CA50,CA242,CA724,CEA,CA199 Node Metastasis Predictive Value To Cardia Cancer Lymph Node

Background:In recent years, the incidence rate of cardiac cancer abroad increased significantly.Although the overall decline in the incidence of gastric cancer in China,But the cardia cancer incidence is rising.Lymph node metastasis are the important factors influencing the prognosis of cardia cancer.The value of tumor markers in the diagnosis of cardia cancer lymph node metastasis.This is a problem of clinical significance.Objective:Explore the tumor markers predictive value of cardia cancer lymph node metastasis.Methods:In February 2009 to December 2013 in the first affiliated hospital of xiamen university in 135 patients with cardia cancer were included in this study.All patients with lymph node metastasis is confirmed by operation and pathology,and imaging.All patients were detection of tumor markers in the same way.By using rank and inspection analysis tumor markers in statistical differences between the two groups(P<0.05).And using ROC curve,and the evaluation of the area under curve of the tumor markers in judging the predictive value of cardia cancer lymph node metastasis.Application of stepwise Logistic regression and ROC curve to evaluate the CEA, CA199, CA242 detection and joint detection alone predictive value of cardia cancer lymph node metastasis.Results:CA50 and CA724 in the lymph node metastasis group and on statistical difference between group without lymph node metastasis(P>0.05),Using the area under the ROC curve analysis,CA724 area under the curve is 0.545(95 %confidence interal0.444-0.645).CA50 area under the curve is 0.471(95%confidence interal0.373-0.569).The CEA,CA242,CA199 in statistical differences between the two groups.CEA area under the curve is 0.645(95 % confidence interal0.55-0.739).CA199 area under the curve is 0.991(95 % confidence interal0.980-1.000).CA242 area under the curve is 0.968(95 % confidence interal0.943-0.992).The CEA,CA199,CA242 the best threshold to predict cardia cancer lymph node metastasis(sensitivity,specific degrees),respectively 3.935ng/m L(40.9%?80.4%)?13.845U/m L(94.3%?97.8%)?11.045IU/ML(88.6%?91.3%).Stepwise Logistic regression analysis model to predict variable area under the receiver-operating characteristic curve is 0.981, CEA, CA199, CA242 three joint detection sensitivity and specific degrees(96.2%, 87.4%), respectively.Conclusion:The CEA,CA199,CA242 prediction has important reference value to cardia cancer lymph node metastasis.CA199,CA242 is more applicable to predict cardia cancer lymph node metastasis.Three joint detection of CEA, CA199, CA242 cardia cancer lymph node metastasis prediction value is superior to the single detection for each indicator, predictive value of cardia cancer lymph node metastasis.Do not recommend using CA724 and CA50 asprediction index of cardia cancer lymph node metastasis.