Changes In Plasma Level Of Ca19-9,ca72-4,cea In Gastric Cancer Patients After Chemotherapy

Gastric cancer (GC) is of the highest incidence in the digestive system as a global malignant tumor.Mortality rate is in the second among all malignancies. The mainstream cure for stomach cancer is surgical removal in a early stage.There are about 2/3 patients are already of advanced stage when diagnosed.The post-operative recurrence is still high. Stomach cancer relapses extremely high ranging from 50% to 70% postoperatively. The Five year survival rate is 10% to 30%. Chemotherapy is the main therapy for the advanced Gastric cancer which is not operable. At present, plasma tumor markers are widely adopted in the diagnosis of gastric cancer. Literatures about the role of plasma tumor markers in the evaluation of the therapeutic effect are rare. This study is to detect the levels of plasma CA19-9, CA72-4 and CEA in patients with gastric cancer and to evaluate the effect of the combined regime of oxalipalitin(L-OHP) plus 5-fluorouracil(5-Fu)/calcium folinate(CF). Also to determine the feasibility of the application of CA19-9, CA72-4 and CEA in combination as an index of therapeutic efficacy and prognosis.Objective:To determine the correlation between variations in the serum level of CA19-9, CA72-4 and CEA in gastric cancer patients and the objective response after chemotherapy.Methods:Patients with at least one abnormal tumor marker out of CA19-9, CA72-4 and CEA were recruited in this study. The regimen was L-OHP 130mg/m2 ivgtt dl, 5-Fu 450mg/m2 ivgtt dl-5/CF 200mg/m2 ivgtt dl-5, in every 3 weeks. The response and side effects were evaluated after two cycles. The plasma levels of CA19-9, CA72-4 and CEA before and after chemotherapy were detected by the electrochemiluminescence assay. Also we analyzed the correlation between the tumor marker levels and the other clinical variables. Results:Of 52 patients with gastric cancer enrolled, the normal rates of CA19-9, CA72-4 and CEA were 44.23%(23),30.77%(16) and 42.31%(22), respectively. After chemotherapy, the normal numbers of CA19-9, CA72-4 and CEA were18,14 and 19, respectively. The turn-over numbers were 5,2 and 3, respectively.The abnormality rates of CA19-9, CA72-4 and CEA were 55.77%(29), 69.23%(36) and 57.69%(30), respectively.In 29 patients with abnormal CA19-9 before chemotherapy, there was statistically significance between the mean levels before and after treatments(12.23U/ml vs.7.00U/ml, P<0.01). In 36 patients with abnormal CA72-4 before chemotherapy, there was statistically significance between the mean levels before and after treatments(17.16U/ml vs.12.00U/ml, P<0.01). In 30 patients with abnormal CEA before chemotherapy, there was statistically significance between the mean levels before and after treatments(15.36 ng/ml vs.13.86 ng/ml, P<0.01).The effect of chemotherapy on the plasma CA19-9 level were associated with clinical staging. The significantly variations were observed inⅢandⅣ stages(23.1% vs.62.5%, P<0.05). The effect of chemotherapy on the plasma CA72-4 level were associated with the clinical pathology grade and therapeutic efficacy. The significantly variations are observed in high-moderate and low-undifferentiated grades(36.4% vs.85.7%, P<0.05). The significantly variations were observed in chemotherapy effective and chemotherapy invalid(83.3% vs. 27.8%, P<0.05). The effect of chemotherapy on the plasma CEA level was associated with histologic grade. The significantly variations were observed in high-moderate and low-undifferentiated grades (23.5% vs.61.5%, P<0.05).The effect of chemotherapy on the plasma level of the unity CA19-9, CA72-4 and CEA level were associated with clinical staging, histologic grade and therapeutic efficacy, with statistically significance (P<0.05).Therapeutic efficacy among 52 patients were 5 patients of Complete Response (CR),17 of Partial Response(PR),19of Stable Disease(SD),11 of Progressive Disease(PD). The Adverse Drug Reactions (ADRs) were myelosuppression gastrointestinal side effects and neurotoxicity.Conclusion:Chemotherapy can decrease the plasma CA19-9, CA72-4 and CEA levels in gastric cancer. The plasma CA19-9, CA72-4 and CEA levels may have predictive value for the efficacy of chemotherapy.