| Objective: This article aims to explore the relationship between the levels of Tspan9 and CEA,CA199,CA724,and CA242 in patients with advanced gastric cancer,and explore the relationship between their levels and clinicopathological characteristics of patients with advanced gastric cancer,and investigate their value in predicting the efficacy of neoadjuvant chemotherapy for advanced gastric cancer.Methods: We retrospectively screened 128 patients with advanced gastric cancer confirmed by pathology and imaging who received neoadjuvant chemotherapy in the oncology department of the Affiliated Hospital of Qingdao University from February 2014 to January 2018.A total of 128 patients were screened.With the patient's informed consent,biopsy tissue samples were obtained from the pathology department.The expression of Tspan9 in gastroscope biopsy tissue before neoadjuvant chemotherapy in gastric cancer patients was detected by immunohistochemistry,which was the expression level of patients before receiving neoadjuvant chemotherapy.The levels of CEA,CA199,CA724,and CA242 in the serum of patients before and after neoadjuvant chemotherapy were evaluated.The efficacy of neoadjuvant chemotherapy was evaluated using abdominal enhanced CT and Response Evaluation Criteria in Solid Tumors(RECIST)before and after neoadjuvant chemotherapy.The relationship between the levels of Tspan9,CEA,CA199,CA724,CA242 and clinicopathological characteristics was analyzed.The relationship between the expression levels of Tspan9 before neoadjuvant chemotherapy and the changes in the expression levels of CEA,CA199,CA724,and CA242 before and after neoadjuvant chemotherapy and the efficacy of chemotherapy was analyzed.Results: In the present study,the disease control rate of neoadjuvant chemotherapy was 89.8%(115/128),and the disease progression rate was 10.1%(13/128).Before neoadjuvant chemotherapy,the positive rate of high expression Tspan9 was 47.7%(61/128).High Tspan9 expression was associated with poor tumor differentiation,larger tumor diameter,deeper invasion depth,lymph node metastasis and higher tumor stage(P = 0.044,P = 0.015,P = 0.042,P = 0.039,P = 0.008).In the disease progression group,Tspan9 high expression patients were significantly more than Tspan9 low expression patients,and Tspan9 high expression was significantly correlated with disease progression(P = 0.005).Among patients with advanced gastric cancer,49 patients had elevated CEA levels with a positive rate of 38.3%;36 patients had a CA199 level increase with 28.1%,47 patients had a CA724 level increase with a positive rate of 36.7% 34 patients showed an increase in CA242 levels,the positive rate was 26.6%;82 patients showed an increase in one or more tumor markers,the positive rate of combined monitoring was 63.9%.The positive detection rate of CEA is associated with a higher degree of differentiation,lymph node metastasis and disease progression(P = 0.001,P = 0.011,P = 0.037),and the positive detection rate of CA724 is associated with vascular invasion and a higher clinical TNM stage(P = 0.008,P = 0.008),the positive detection rate of joint detection was related to the depth of invasion,lymph node metastasis and p TNM stage(P = 0.03,P = 0.023,P = 0.049),the positive detection rate and differentiation of CA199 and CA242 The degree,depth of invasion,lymph node metastasis,vascular invasion,and p TNM stage were irrelevant.Compared with the baseline levels of the four tumor markers before neoadjuvant chemotherapy,the average level of the four tumor markers after chemotherapy was reduced,especially CEA,CA724 and CA242 were significantly reduced(P = 0.041,P = 0.008 and P = 0.012),respectively,these three tumor markers in the disease control group(CR + PR + SD),the decline in the level of the markers was more significant than the disease progression group(PD)group(P = 0.020,P = 0.034 and P = 0.030,respectively).Conclusion: The present study found that the expression level of Tspan9 was related to clinical features.The high expression of Tspan9 was related to poor tumor differentiation,larger tumor diameter,deeper invasion depth,lymph node metastasis and higher tumor stage.The expression of Tspan9 varied greatly under different treatment effects.The high expression of Tspan9 was associated with disease progression.After neoadjuvant chemotherapy,the average levels of CEA,CA199,CA242,and CA724 decreased compared with before chemotherapy.Among them,the levels of CEA,CA242,and CA724 decreased significantly,and the decreased levels of CEA,CA724,and CA242 were related to the efficacy of neoadjuvant chemotherapy.The change level of CA242 can be used to predict the efficacy of neoadjuvant chemotherapy. |
PDF Full Text Request