| Objective: To analyze the expression levels of serum tumor markers carcinoembryonic antigen(carcino embryonic antigen,CEA),carbohydrate antigen 724(carbohydrate antigen 724,CA724),heat shock protein 60(heat shock protein 60,HSP60)and malignant tumor specific growth factor(tumor Supplied Group of Factors,TSGF)in the serum of patients with gastric cancer,and to explore the clinical application value of their combined dynamic detection in early diagnosis,disease monitoring,treatment guidance and prognosis evaluation of gastric cancer.Methods: Three groups were selected as the study subjects,including 127 patients with gastric cancer(malignant tumor group),50 patients with benign gastric lesions(benign control group)and 50 healthy subjects(control gr normal oup).ECL detection method and enzyme-linked immunosorbent assay were used to detect serum concentration of CEA,CA724,HSP60 and TSGF,and statistical analysis was adopted to analyze the expression of tumor markers CEA,CA724,HSP60 and TSGF in the serum of three groups.Furthermore,the correlation between serum tumor markers CEA,CA724,HSP60 and TSGF and benign and malignant diseases in the stomach was studied,and the correlation between the level of serum tumor marker and different clinical pathological factors,including sex,age,tumor location,tumor size,invasive stomach wall depth,differentiation,clinical stages,ascites,regional lymph node metastasis,distant metastasis,recurrence and post-treatment was evaluated.Moreover,the combined detection of four tumor markers by CEA,CA724,HSP60 and TSGF and the value of each single and partial combination detection for the diagnosis of gastric cancer(sensitivity,specificity,accuracy,positive predictive value,negative predictive value)was analyzed.And the clinical application value of combined dynamic detection in early diagnosis,monitoring of disease,treatment guidance and prognosis evaluation of gastric cancer was explored.Results:(1)The concentrations of serum CEA,CA724,HSP60 and TSGF in patients with gastric cancer were significantly higher than that of benign group and the healthy control group,the difference was statistically significant(P<0.01).There was no significant difference between the benign control group and the normal control group(P>0.05).(2)There was no significant correlation with patients' sex,age and the site of tumor(P>0.05),but was significantly correlated with the tumor size,depth of invasion of the stomach,degree of differentiation,clinical stage,ascites,regional lymph node metastasis,distant metastasis,and recurrence after treatment(P<0.05).The larger the tumor volume and the deeper the infiltrating stomach wall,the higher the expression level of serum markers.The levels of serum CEA,CA724,HSP60 and TSGF in the middle-late stage group,the poorly differentiated group,the ascites group,the metastatic group,the relapse group and the pre-treatment group were higher than those in the early group,the highly differentiated group,the non-peritoneal effusion group,the non-metastasis group,the recurrence-free group and the post-treatment group(P<0.05).(3)Diagnostic sensitivity of CEA,CA724,HSP60 and TSGF in gastric cancer were 49.61%,54.33%,55.12%,45.67%,specificity were 94.00%,92.00%,92.00%,90.00%,accuracy were 62.15%,64.97%,65.54%,58.19%,diagnostic sensitivity of every three in combination(CEA+ CA724+HSP60,CEA+CA724+TSGF,CA724+HSP60+TSGF,CEA+HSP60+TSGF)in gastric cancer were 73.23%,72.44%,74.02%,70.08%,specificity were86.00%,84.00%,84.00%,86.00%,accuracy were 76.84%,75.71%,76.84%,74.58%.Despite sensitivity and accuracy of combined dectection of the four tumor markers CEA,CA724,HSP60 and TSGF were significantly improved significantl,which were 95.28% and 90.96% respectively,and were significant difference with the individual and partial combination detection.Conclusions: Serum tumor markers CEA,CA724,HSP60 and TSGF combined dynamic detection improve the diagnostic efficacy of gastric cancer,and reduce misdiagnosis and missed diagnosis.Therefore,dynamic detrction has guiding significance for monitoring the development of the disease,predicting recurrence and metastasis,evaluating the efficacy and efficacy evaluation. |
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