| Background:DR-70 is a novel substance discovered by American Donald Rounds in the carcinogenesis of normal cell culture in 1970.It has also been detected in the serum of various tumor patients.The concentration level was found to be significantly higher than that of the general healthy population.When a malignant tumor or the like occurs,the level of DR-70 in the blood of the human body increases,and changes as the condition progresses.It was first demonstrated as a novel tumor marker in 1992 by Justice et al.It has been confirmed that DR-70 is a kind of characteristic proteolytic enzyme secreted by tumor cells,and the relative molecular weight is 2700-12000 Dalton,which can cause the dissolution of fibrin and the like.Quantitative detection of DR-70 levels can be achieved by detecting all degradation products of cancer-induced fibrin and fibrinogen,including detection of unique "IPDP" cancer-related degradation products.As a malignant tumor marker,DR-70 has the advantages of simple detection method,moderate price and good repeatability.In terms of the sensitivity of detection of gastric cancer,DR-70 is significantly superior to CEA and CA 19-9,and DR-70 has the highest positive rate of gastric cancer detection among various malignant tumors.Currently widely used CEA is not an ideal indicator for blood cancer screening,because CEA is firmly attached to cancer cells as an adhesion molecule.In contrast,DR-70 is free to diffuse in the blood,thereby improving its positive rate of detection in patients.DR-70 is closely related to gastric cancer and can be used as an important monitoring index for gastric cancer progression.However,there are few reports on the relationship between DR-70 and gastric cancer,and no independent and in-depth research reports on the correlation between DR-70 and clinical and pathological features of gastric cancer have been found.Objectives :This article aims to retrospectively analyze the serum DR-70 levels of 129 patients with gastric cancer and the clinical and pathological features of gastric cancer during the period from August 2017 to August 2018 in Jinan Central Hospital affiliated to Shandong University.The relationship between the two is discussed in detail,so that it is convenient for clinicians to have a deeper understanding of the diagnostic value of DR-70 as a novel tumor marker in the clinicopathological features of gastric cancer,and to help to more effectively and comprehensively evaluate the progress of gastric cancer.Methods:This study collected 135 patients with clear gastrointestinal endoscopy and postoperative pathological diagnosis during the hospitalization of gastrointestinal surgery,gastroenterology and oncology department in Jinan Central Hospital Affiliated to Shandong University from August 10,2017 to August 30,2018.Of the 135 patients with gastric cancer,129 of them met the admission criteria and exclusion criteria and collect serum from 129 patients on an empty stomach in the early morning before surgery.First,the expression level of DR-70 in serum was detected by chemiluminescence method,and then grouped according to DR-70 serum level's negative positive determination threshold.The pretreatment variables in this study included the age,sex,Hp infection of the two groups of patients,whether the gastric cancer had distant metastasis or metastasis of peripheral lymph node clinical stage,surgical mode,location,size,degree of infiltration,and degree of differentiation.The aim of this study was to analyze the relationship between serum DR-70 positivity and different clinical and pathological features of gastric cancer.The 8th edition of the TNM clinical staging standard for gastric cancer(2018)developed by the American Joint Committee on Cancer(AJCC)was applied to the clinical stage of TNM in patients with gastric cancer.The statistical software used for statistical analysis of the data of this study was SPSS 25.0 statistical software,and the significance test of counting data was performed by test.Statistical analysis was performed using a two-sided test,and if P < 0.05,both were considered to have statistically significant differences.Results :Among the 129 patients with gastric cancer who were included in the study,serum DR-70-positive patients accounted for 76.8%(99/129)of the total number of patients with gastric cancer.There was a statistically significant difference between the DR-70 positivity and whether there was peripheral lymph node metastasis of gastric cancer(=4.361,P=0.037).There was a statistically significant difference between the DR-70 positivity and the degrees of infiltration of gastric cancer(=10.953,P=0.012).There was a statistically significant difference between the DR-70 positivity and the degree of differentiation of gastric cancer(=7.839,P=0.049).There was a significant statistical difference between the DR-70 positivity and whether there was distant metastasis of gastric cancer(=4.082,P=0.043).There was a statistically significant difference between the DR-70 positivity and the clinical scores of gastric cancer(=9.955,P=0.041).There was a statistically significant difference between the DR-70 positivity and the surgical methods of gastric cancer.(=9.924,P =0.042).There was no significant statistical difference between DR-70 positivity and age(=0.45,P =0.502).There was no statistically significant difference between DR-70 positivity and gender(=0.369,P=0.544).There was no statistically significant difference between the DR-70 positivity and the size of gastric cancer(=1.461,P=0.227).There was no statistically significant difference between the DR-70 positivity and the sites of gastric cancer(=0.747,P=0.688).There was no statistically significant difference between the DR-70 positivity and whether it was infected Hp(=1.757,P=0.185).24 of 129 patients were positive for serum DR-70 and had distant metastasis(17.3%),including gastric cancer with liver metastasis,abdominal metastasis,lung metastasis,bone metastasis.There were 13 cases,15 cases,8 cases,and 3 cases,respectively accounting for 54.2%,62.5%,33.3%,and12.5% of the total number of distant metastasis.All the cases of distant metastasis were accompanied by peripheral lymph node metastasis.Conclusion:Whether the serum DR-70 is positive in patients with gastric cancer is related to the distant metastasis of gastric cancer,the presence or absence of peripheral lymph node metastasis,clinical stage,surgical mode,infiltration degree and degree of differentiation.When gastric cancer is accompanied by peripheral lymph nodes and distant metastasis,the higher the clinical stage,the higher the degree of infiltration,the probability of DR-70 positivity is greater,but the patient's age,gender,whether it is infected with Hp,the size and location of gastric cancer is not necessarily related.When the serum DR-70 is positive and the gastric cancer is accompanied by distant metastasis,the abdominal cavity and liver are the main distant metastatic sites,and distant metastases are all accompanied by peripheral lymph node metastasis.Therefore,in the operation of gastric cancer with DR-70 positive and distant metastasis,the surrounding lymph nodes should be strictly cleaned.By detecting whether the serum DR-70 is positive in gastric cancer patients,it is helpful for clinicians to conduct a more effective and comprehensive assessment of the extent of progression of gastric cancer in patients. |
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