Correlation Between Serum VEGF And TAP Levels And Early Diagnosis And Clinical Characteristics Of Gastric Adenocarcinoma

Background and ObjectiveGastric cancer(GC)is the third leading cause of cancer-related deaths.The vast majority of patients are diagnosed at an advanced stage with a poor prognosis.Gastric adenocarcinoma is the most common pathological type of all gastric malignancies.Therefore,improving the early diagnosis rate of Gastric adenocarcinoma is very important to reduce the mortality of overall gastric cancer and improve the prognosis of overall gastric cancer.At present,the commonly used clinical tumor markers for gastric cancer include AFP,CEA,CA125,CA72-4,CA19-9 and CA50,which can improve the detection rate of gastric cancer and contribute to the early diagnosis and treatment of gastric cancer.Tumor abnormal proteins(TAP)are glycoproteins with abnormal sugar chain structure and calcium-histone complexes released by cancer cells during metabolism,which are released into the blood and coexist in the peripheral blood.The concentration of TAP can indirectly indicate the degree and amount of cancerization.Vascular endothelial growth factor(VEGF)is an endothelial regulatory factor.It promotes the proliferation and metastasis of blood vessels and lymphatic vessels in tumor tissues by allowing vascular endothelial cells to rapidly proliferate and increase the permeability of blood vessels.This study compared the levels of VEGF,TAP and other commonly used tumor markers in patients with benign stomach disease,gastric intraepithelial neoplasia and gastric adenocarcinoma,explore the correlation with the clinical features of gastric adenocarcinoma,to evaluate its value in the early diagnosis of gastric adenocarcinoma and the diagnostic efficacy of lymph node metastasis.MethodsA total of 44 patients with benign gastric disease,22 patients with gastric intraepithelial neoplasia and 104 patients with gastric adenocarcinoma who were admitted to the First Affiliated Hospital of Zhengzhou University from June 2018 to June 2019 were selected as the research objects.Compare the differences of serum VEGF,TAP in each group and analyze the correlation between their value in the early diagnosis of gastric adenocarcinoma and the clinical characteristics of gastric adenocarcinoma.This study has been approved by the Ethics Committee of the First Affiliated Hospital of Zhengzhou University.The clinical data of the subjects were statistically analyzed,apply SPSS 23.0 software for statistical analysis of all data.The differences were considered statistically significant at P<0.05.Results1.The age of gastric adenocarcinoma(61.48±9.78)was higher than that of non-gastric adenocarcinoma(54.83±12.67),the difference was statistically significant(P=0.000);the gender composition ratio of the two groups was significantly different(P=0.000),the prevalence of men is higher than that of women.2.The levels of serum VEGF and TAP in patients with gastric adenocarcinoma were significantly higher than those in patients with non-gastric adenocarcinoma.The changes were similar to the tumor markers AFP?CEA,CA125,CA72-4,and the differences were statistically significant(P=0.000,0.000).3.All patients were divided into benign gastrosis group,gasttric intraepithelial neoplasia group,stage ?,?,? gastric adenocarcinoma group.Except for the CA19-9,there was no statistically significant difference between the five groups(P=0.197),other VEGF,TAP,AFP,CAE,CA125,CA72-4 levels,there were significant differences between the five groups(P<0.05);pairwise comparison found that the levels of VEGF and TAP gradually increased with the severity of gastric disease.4.The levels of VEGF,TAP,AFP,CAE,CA125,and CA72-4 were positively correlated with the severity of gastric disease(all P<0.05),VEGF and TAP were strongly correlated(r=0.909,r=0.714);CEA and CA125 are moderately correlated(r=0.476,r=0.480);CA72-4 and AFP are weakly correlated(r=0.378,r=0.158);There was no significant correlation between CA19-9 and the severity of stomach diseases(r=0.133 P=0.085).5.There is no significant difference in the level of gastric adenocarcinoma serum TAP in terms of age,gender,tumor site,degree of differentiation,and lymph node metastasis(P>0.05),only the difference in pathological TNM stage is statistically significant(P=0.000),phase ? level is significantly higher than phase ?(P=0.005).There is no significant difference in the levels of serum VEGF in gastric adenocarcinoma in terms of age,gender and tumor site(P>0.05),differences in pathological TNM stage,degree of differentiation,and lymph node metastasis were statistically significant(all P<0.001).6.Among all the markers,the levels of VEGF,CEA,CA125,and CA72-4 were statistically significant between the two groups of gastric adenocarcinoma lymph node metastasis(all P<0.05),the area under the ROC curve(AUC)of VEGF was the largest.The AUC is 0.963.The optimal cut-off value of VEGF for the diagnosis of gastric adenocarcinoma lymph node metastasis is 199.5ng/L,with a sensitivity of 98.1%,a specificity of 90.2%,and a Youden index of 0.883.7.Binary logistic regression analysis showed that serum VEGF and TAP levels were still independent risk factors for gastric adenocarcinoma after adjusting for other risk factors such as age,gender,CEA,CA125,CA19-9,CA72-4(OR=1.042 P<0.001;OR=1.074 P=0.001).Conclusions1.Increased serum VEGF and TAP levels are associated with the development of gastric adenocarcinoma.2.Serum VEGF and TAP are independent risk factors for gastric adenocarcinoma and can be considered as tumor markers for gastric adenocarcinoma.3.Serum VEGF level is closely related to tumor TNM stage,differentiation degree,and lymph node metastasis.With the progress of gastric adenocarcinoma and the increase of malignant degree,VEGF shows an upward trend.Its level is helpful to predict the stage and malignancy of gastric adenocarcinoma,and has great value in observation of curative effect and prognosis.4.Serum TAP level is only closely related to the TNM stage of gastric adenocarcinoma,and has no obvious correlation with lymph node metastasis.It has certain predictive significance for pathological stage of gastric adenocarcinoma,but has low diagnostic efficacy for lymph node metastasis.5.Serum VEGF has certain diagnostic significance for lymph node metastasis of gastric adenocarcinoma,and has a high reference value.Considering it as an indicator for predicting lymph node metastasis of gastric adenocarcinoma,it has certain guiding significance for the formulation of postoperative adjuvant chemotherapy for patients.