Expression Of CEA And CA19-9 In Gastric-associated Diseases And Hemodilution Effect Of Them

Objective To investigate the expression characteristics and diagnostic value of tumor marker CEA,CA19-9 in gastric diseases,especially in atrophic gastritis,intraepithelial neoplasia and gastric cancer.To further analyze the relationship between CEA,CA19-9 and clinicopathological features and the effect of obesity-related hemodilution of CEA and CA19-9 in patients with gastric cancer.Method 96 patients with gastric cancer and 57 patients with intraepithelial neoplasia and 61 patients with atrophic gastritis and 94 patients with peptic ulcer and 116 patients with non-atrophic gastritis between January 2016 and June 2018 were enrolled.Serum levels and positive rate of CEA and CA19-9 in five groups were examined by electrochemical luminescence assay,so as to analyze the early diagnosis value of single and combined detection of CEA and CA19-9 in intraepithelial neoplasia and gastric cancer as well as their relationships with clinic factors in gastric cancer.According to the body mass index,the CEA,CA19-9 and clinicopathological features of different BMI groups in patients with gastric cancer were analyzed.Besides,the effects of BMI on the two tumor markers were discussed to determine whether obesity-related hemodilution effect of CEA and CA19-9.Results 1?The levels of CEA in gastric cancer group and intraepithelial neoplasia group were significantly higher than those in other three groups(P < 0.05),but there were no significant difference between the two groups(P >0.05).In gastric cancer group,the level of CA19-9 was higher than gastritis(atrophic+ non-atrophic)and ulcer group.The positive rate of CEA in gastric cancer group was higher than that in other groups,but there was no significant difference compared with intraepithelial neoplasia group and nonatrophic gastritis group,while the positive rate of CA19-9 in gastric cancer group was higher than that in other groups(P<0.05).2?The diagnostic sensitivity was 62.5% when the optimal cut-off value for CEA was 2.08ng/ml,and the specificity was 97.0% when 26.28U/ml was used as the optimal cut-off value for serum CA19-9.Combined detection of those two indices,the area under ROC curve of 0.748,the sensitivity of 55.2%,the specificity of 89.7%,Although the increase of AUC is not obvious compared with CEA alone,but the combined detection takes both sensitivity and specificity into account and has better diagnostic efficiency.3?In 96 patients with newly diagnosed gastric cancer,there were no significant differences between serum CEA positive rate and pathological type,depth of invasion and lymph node metastasis(P> 0.05),but related to age and sex(P < 0.05).The positive rate of serum CA19-9 were correlated with the degree of tumor differentiation,depth of invasion and lymph node metastasis(P < 0.05).4?In gastric cancer patients,the BSA-based plasma volume and the HCT-based plasma volume were significantly associated with higher BMI(P<0.001).The BSA-based CEA?CA19-9 amount had no association with BMI.The level of CEA?CA19-9 was not also significantly associated with increasing BMI.Among these gastric cancer patients,more than half of the patients were categorized as normal BMI,8.33% as low BMI,and 40.6% as high BMI.Age,gender,degree of differentiation,depth of invasion,lymph node metastasis and CEA and CA19-9 positive rate were not different between BMI groups.Conclusion 1?Both CEA and CA19-9 are closely related to the progression of gastric mucosal lesions,which can not only reflect the changes of cancerous mucosa,but also reflect the mucosal changes of precancerous lesions such as intraepithelial neoplasia and atrophic gastritis.CEA is more sensitive in detecting gastric diseases and can better identify early gastric mucosa with malignant tendency.While detection of gastric cancer by CA19-9 is more specific and can better distinguish benign and malignant diseases.Combined two indices can improve the diagnostic accuracy of gastric cancer.2?The positive rate of CA19-9 are related to age and sex,while the positive rate of CA19-9 are correlated with the degree of tumor differentiation,depth of invasion and lymph node metastasis.3?The plasma volume are significantly associated with higher BMI.But the effect of obesity-related hemodilution on CEA and CA19-9 concentration were not found.Age,gender,degree of differentiation,depth of invasion,lymph node metastasis and CEA and CA19-9 positive rate were not different between BMI groups.