Application Value Research Of Serum Tumor Markers CEA、CA19-9and CA72-4in Gastric Cancer

Objective：CEA, CA19-9and CA72-4are common serum tumor markers of gastriccancer, the objective of this study is to investigate application value of the three markersin gastric cancer systematically and focus on the correlation between tumor markers andgastric cancer pathological parameters and their value in the evaluation of curative effect.Then establish two discriminant function of diagnosis of gastric cancer and regionallymph node metastasis. Through these analyses, I would like to provide certain referenceon CEA, CA19-9and CA72-4application value in gastric cancer.Methods：To Select111cases of patients with gastric cancer (all patients are thefirst time to be treated) as gastric cancer group from January2012to July2013from ourdepartment, who were diagnosed by preoperative gastroscopy examination andpostoperative pathological diagnosis. Then121patients with gastric benign disease andoutpatients during the same period were selected as control group. By using Cobas e601analyzer to detect serum concentrations of CEA, CA19-9and CA72-4of the two groupsrespectively, and analyze the related clinical data of gastric cancer patients. Finally,discriminant analysis method is adopted to establish two discriminant function ofdiagnosis of gastric cancer and regional lymph node metastasis.Results：（1）The median of serum concentrations of CEA, CA19-9and CA72-4in gastriccancer group are2.81ng/mL,9.21U/mL,2.77U/mL, the median of serum concentrationsof CEA, CA19-9and CA72-4in control group are1.33ng/mL,6.40U/mL,1.21U/mL, serum concentrations of the three markers in gastric cancer group are higher than thecontrol group, the differences have statistical significance (exact probability P <0.001).（2）The expression positive rate of CEA, CA19-9and CA72-4in gastric cancergroup are17.1%,22.5%and29.7%, while the expression positive rate of CEA, CA19-9and CA72-4in the control group are8.3%,6.6%and5.0%, the differences havestatistical significance (exact probability P <0.05).（3）Single detection sensitivity of CEA, CA19-9and CA72-4for the diagnosis ofgastric cancer are17.1%,22.5%and29.7%respectively, CA72-4has the highestsensitivity; for two joint detection, CA19-9+CA72-4has the highest sensitivity with37.8%; for three joint detection, the sensitivity can reach43.2%. Secondly, the specificityof CEA, CA19-9and CA72-4for the diagnosis of gastric cancer can be as high as above90%and CA72-4is as high as95.0%. However, joint detection can reduce the specificity,and the more joint items, the lower specificity.（4）The positive rate of tumor markers in Ⅲ~Ⅳ stage gastric cancer is higherthan Ⅰ~Ⅱ stage, the difference has statistical significance (exact probability P<0.01).The positive rate of tumor markers in regional lymph node metastasis patients is higherthan patients without regional lymph node metastasis, the difference has statisticalsignificance (exact probability P<0.05).（5）For those patients who are improved after operation, the median of serumconcentrations of CEA, CA19-9and CA72-4of post-operation are lower thanpre-operation, the differences have statistical significance (exact probability P <0.01).（6）Typical discriminant function of the diagnosis of gastric cancer is Y=﹣0.384﹣0.002Χ1+0.004Χ2+0.026Χ3, among them, Χ1, Χ2, Χ3refer to serum concentration ofCEA, CA19-9and CA72-4respectively. If Y>0, we can predict the diagnosis is gastriccancer. The discriminant function discriminates27.9%of gastric cancer cases and97.5%of the control group cases correctly, the total accuracy is64.2%. Typical discriminantfunction of regional lymph node metastasis is Y=﹣0.497﹣0.001Χ1+0.003Χ2+0.017Χ3,among them, Χ1, Χ2, Χ3refer to serum concentration of CEA, CA19-9and CA72-4 respectively. If Y>0, we can predict the patient to be with regional lymph nodemetastasis. The discriminant function discriminates32.3%gastric cancer cases withregional lymph node metastasis and95.9%of gastric cancer without regional lymph nodemetastasis correctly, the total accuracy is60.4%.Conclusions：（1）Serum concentrations and expression positive rate of CEA, CA19-9andCA72-4in gastric cancer patients are significantly higher than the control group,therefore, to detect the expression levels of the three tumor markers can be used as afavorable assistant method for the diagnosis of gastric cancer.（2）For single detection, the CA72-4is the best marker, for two joint detection,CA19-9+CA72-4is the best combination, for three joint detection, the sensitivity canreach43.2%. However, joint detection can reduce the specificity of detection. Therefore,in the clinic, selecting the best detection combination can improve the sensitivity andavert too low specificity.（3）CEA, CA19-9and CA72-4are closely associated with the pathologicalcharacteristics of gastric cancer, all of them can be used as predicted factors of gastriccancer stage and regional lymph node metastasis. In item of predicting the gastric cancerstage, CEA and CA72-4are better than that of CA19-9, in term of predicting regionallymph node metastasis, CA72-4is better than that of CEA and CA19-9.（4）CEA, CA19-9and CA72-4have certain clinical significance in the evaluationof curative effect of gastric cancer, they can be used as reference factors in evaluatingcurative effect of gastric cancer.（5）The two discriminant function show favorable discriminant efficiency,therefore, they have certain clinical application value.