| Objective:To explore the application value of age and serum tumor marker detection in the diagnosis of gallbladder malignant tumors(GBC)in gallbladder diseases,analyze the risk factors for the occurrence of gallbladder malignant tumors,and develop diagnostic prediction models;To analyze the correlation between the expression of platelet-leucocyte kinase substrate 2(PLEK2)in gallbladder carcinoma tissue and its clinicopathological characteristics,and its influence on the prognosis of patients with gallbladder carcinoma after operation.Methods:A retrospective analysis was made of 46 cases(recorded as malignant group)of cholecystectomy or radical resection of gallbladder carcinoma in Chao-Hu Hospital affiliated to Anhui Medical University from March 2017 to March 2022.A total of 54 cases(recorded as benign group)were randomly selected for cholecystectomy in the same period.Compare the clinical symptoms,laboratory tests,and imaging examinations between the benign and malignant groups for statistical differences,and include them in binary logistic regression analysis to screen out the relevant factors for the occurrence of gallbladder malignant tumors,and draw a column chart.The ROC curve was used to analyze the application value of single serum tumor marker and age combined with tumor marker detection in the diagnosis of gallbladder carcinoma,and a positive diagnostic test table was made.The correlation between the expression of PLEK2 and the clinicopathologic characteristics of patients was analyzed by immunohistochemical staining of gallbladder tissue;The follow-up data of patients in malignant group were collected to analyze the effect of PLEK2 expression on the survival of patients with gallbladder carcinoma after operation.Results:There were significant differences in age,hemoglobin,neutrophils,lymphocytes,neutrophil lymphocyte ratio,liver enzymes,bilirubin,albumin,serum tumor markers,gallbladder wall thickness,and presence or absence of gallstones between the benign and malignant groups(p<0.05).Multivariate analysis showed that age,CA199 positivity,and presence or absence of gallstones were significantly correlated with the occurrence of gallbladder malignant tumors.In the ROC diagnosis curve analysis of patients in the benign group and malignant group,the diagnosis value of age,CA199,CA125 was medium(AUC 0.818,0.800,0.746),the diagnosis value of CEA and CA153 was low(AUC 0.688,0.682),and the diagnosis value of age combined with CEA,CA199,CA153,CA125 was medium(AUC 0.841,0.892,0.881,0.886);In the diagnostic test,the specificity of single tumor marker diagnosis is more than 95%,but the sensitivity is generally low;The specificity and sensitivity of age combined with CEA,CA199,CA153 and CA125 were greater than 70%(Youden index was 0.527,0.595,0.523 and 0.573respectively).The expression of PLEK2 was positive in 41 cases of gallbladder carcinoma,but not in benign gallbladder tissues.The expression of PLEK2 was correlated with T stage,lymph node metastasis,CA153 level and sex(p<0.05);A total of 46 patients with gallbladder carcinoma were followed up in September2022.The overall median survival time was 28 months(95% CI: 20-36 months).In Cox risk regression analysis,T stage(p=0.029)and the expression of PLEK2(p=0.018)were independent risk factors affecting the prognosis of patients with gallbladder carcinoma.Conclusion:In the population of patients with benign gallbladder diseases such as gallstones,age,CA199 positivity,and the presence or absence of gallstones are closely related to the occurrence of gallbladder malignant tumors;Age combined with serum tumor marker detection is superior to simple serum tumor marker detection in the differential diagnosis of benign gallbladder diseases and malignant gallbladder tumors;PLEK2 is mostly positive in gallbladder carcinoma tissue,and its positive expression is related to T stage,lymph node metastasis,sex,and CA153 level,which is an independent risk factor affecting the prognosis of gallbladder carcinoma patients. |
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