| Objective: To investigate the clinical application value of single and combined detection of preoperative serum levels of CEA, CA19-9, CA125 and CA72-4 in the diagnosis of gastric cancer.Methods: We retrospectively analyzed 143 patients with gastric cancer, 66 patients with benign gastric disease and 59 healthy individuals from the Second Hospital of Dalian Medical University between January 2014 and December 2014.Patients with gastric cancer and benign gastric disease were identified by gastroscopy and pathology. The group of gastric cancer comprised 31 patients with stageⅠdisease,29 patients with stageⅡdisease, 65 patients with stage Ⅲ disease, 15 patients with stageⅣ disease. Further, the number of patients with early gastric cancer and advanced gastric cancer were 25 and 118, respectively. Preoperative serum levels of CEA,CA19-9, CA125 and CA72-4 in gastric cancer patients were detected by using electrochemiluminescence immunoassay(ECLI). The diagnostic power of single and combined detection of preoperative serum CEA, CA19-9, CA125, CA72-4 in patients with gastric cancer and early gastric cancer were determined by using receiver operating characteristic(ROC) curve.Results: Preoperative serum CEA, CA19-9, CA125 and CA72-4 levels in patients with gastric cancer were remarkably elevated than in benign gastric disease and healthy individuals(P<0.05), except for the difference between preoperative serum levels ofCA125 in patients with gastric cancer and benign gastric disease(P>0.05). The sensitivities of CEA, CA19-9, CA125, and CA72-4 for prediction of gastric cancer were28.0%, 16.7%, 8.4%, and 29.3%, respectively. Then, the group of CEA+CA72-4 with41.3% preoperative positivity possessed the highest sensitivity in two combinations.The group of CEA+CA19-9+CA72-4 with 46.2% preoperative positivity possessed the highest sensitivity in three combinations. Sensitivity of combination of these four markers was 48.3%. ROC analysis showed that the AUC of prediction of gastric cancer for CEA, CA19-9, CA125, and CA72-4 were 0.706, 0.618, 0.587, and 0.740,repectively. Then, the group of CEA+CA72-4 with AUC of 0.798 displayed the optimal diagnostic efficiency in two combinations. The group of CEA+CA19-9+CA72-4 with AUC of 0.799 presented the optimal diagnostic efficiency in three combinations.Moreover, AUC of combination of these four markers was 0.803. Further, ROC analysis showed that the AUC of prediction of early gastric cancer for CEA, CA19-9, CA125,and CA72-4 were 0.577, 0.529, 0.507, and 0.622, respectively. Then, the group of CA125+CA72-4 with AUC of 0.657 showed the optimal diagnostic efficiency in two combinations. The group of CEA+CA125+CA72-4 with AUC of 0.647 presented the optimal diagnostic efficiency in three combinations. Moreover, AUC of combination of these four markers was 0.625. Moreover, preoperative serum levels of these four tumor makers correlated significantly with tumor size, differentiated degree, infiltrated degree,lymphatic metastasis, distant metastasis, and clinical stage, except for the correlation of serum levels of CEA and CA19-9 with differentiated degree(P>0.05).Conclusions: The elevated preoperative serum levels of CEA, CA19-9, CA125 and CA724 can be used as auxiliary methods for diagnosis of gastric cancer. The combined detection of preoperative serum levels of CEA, CA19-9, CA125 and CA724 improves diagnostic sensitivity than single detection for gastric cancer. However, single and combined diagnostic potential of these four tumor markers for diagnosis of early gastric cancer are relatively low. Further, preoperative serum levels of CEA, CA19-9,CA125 and CA724 correlate significantly with the power of cancer invasion. |
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