Study On The Value Of Combined Detection Of CEA,CA242 And NSE In The Differential Diagnosis Of Benign And Malignant Gastric Diseases

Objective:So far there is no single tumor marker with high sensitivity and specificity in the clinical differential diagnosis of benign and malignant gastric diseases.According to references,combination detection of serum tumor maker can improve the diagnostic efficiency of gastric cancer.In this study,by analyzing the correlation between the expression levels of various tumor markers and the characteristics of gastric cancer such as pathological type,TNM stage,differentiation degree,tumor location and tumor size.I would evaluate the diagnosis efficacy of different tumor markers combinations in the differential diagnosis of benign and malignant gastric diseases by various statistical methods,and find out the best combination of serum tumor markers used for the differential diagnosis of benign and malignant gastric diseases.Methods:681 gastric cancer patients verified by gastroscopic pathological biopsy in our hospital from May 2014 to July 2017 were collected for this study.500 persons with gastric benign diseases(including 198 cases of gastritis,174 cases of gastric ulcer and 128 cases of gastric polyp)were selected as the group of benign gastric diseases.The data including age,gender,personal history,family history,history of Helicobacter pylori infection,the expression of serum tumor markers,endoscopy and medical imaging results were collected and analyzed by SPSS 20.0 statistical software.Results:1.The expression levels of CEA,AFP,CA199,CA242,HGH,TPSA,NSE and CPSA in gastric cancer group were significantly higher than those in benign gastric disease group.While the expression levels of CA153 and FER in gastric cancer group were lower than those in benign gastric disease group.However,there was no significant difference in CA125 and HCG expression between the these two groups.2.CEA is the best single tumor marker used for differential diagnosis of gastric benign diseases and gastric cancer,and its AUC value is 0.643,with a sensitivity and specificity of 43.2% and 78.0% respectively.The three tumor markers CEA,CA242 and NSE were screened out by ROC curve and logistic regression analysis as the most relevant biomarker to gastric cancer.Among the all single and combined detection,the combination detection of CEA+CA242+NSE presents the largest area under the curve(AUC=0.669)(p<0.05),and is the appropriate combination of tumor markers used for differential diagnosis of gastric cancer and benign gastric diseases in clinical application.3.The expression level of CEA was correlated to the stage,differentiation degree and tumor size of gastric cancer.The expression level of CA242 was correlated to the stage,location and tumor size of gastric cancer(p<0.05).However,the expression level of NSE was not correlated with the stage,histological type,tumor size,location and differentiation degree of gastric cancer.4.The combination detection of CEA+CA242+NSE improved the differential diagnostic efficiency of benign gastric diseases and gastric cancer.The diagnostic efficiency of the combination detection was higher than that of single detection in diagnosing diffuse gastric cancer,poorly differentiated cancer,gastric antrum cancer and tumor with diameter more than 5cm.Conclusion:1.CEA was superior to CA242 and NSE in the diagnosis of gastric cancer through single tumor marker detection.2.The combined detection of CEA+CA242+NSE can improve the differential diagnostic efficiency of benign gastric diseases and gastric cancer.