| Objective To study the expression levels of CEA,CA19-9,CA72-4,PG,and MG7 AG in different populations with gastric disease,and analyze the diagnostic value of their individual and combined detection in patients with gastric cancer,to provide early screening ideas for medical workers,and further explore the relationship between above five tumor markers and gastric cancer staging,and provide a certain reference for prognostic evaluation.Methods From November 2016 to January 2019,104 patients who were diagnosed with gastric cancer for the first time in Heze Municipal Hospital were selected as the gastric cancer group,and 60 patients who were diagnosed with gastric mucosal intraepithelial neoplasia during the same period were selected as the benign lesion group,outpatient physical examination of 80 patients with normal gastric mucosa or only superficial gastritis were selected as control group.The general conditions and pathological data of the patients were collected.The serum of CEA,CA19-9,CA72-4,PG,and MG7 AG were detected in each group,and the five tumor markers were analyzed for the diagnostic value of gastric cancer.The relationship between five tumor markers and general and pathological data was analyzed to reveal their value in determining prognosis.SPSS 22.0statistical software was used for data analysis.The measurement data was expressed as((?)± s).Two independent samples were tested by t test,and three groups of samples were analyzed by one-way ANOVA,rank sum test was used when the distribution or variance was not uniform,count data was represented by [n(%)],and comparison between groups was tested by chi-square test,spearman correlation analysis was used to analyze the correlation of the grade data.The difference was statistically significant with P <0.05.Results 1.In the gastric cancer group,the positive rates of MG7 AG and PGR in patients with Hp infection were higher than those without Hp infection,and the positive rates of MG7 AG and PGR were higher in patients with drinking history than those patients without drinking history.The difference was statistically significant(P < 0.05).2.The positive rates of CEA,CA19-9,CA72-4,MG7 AG,and PGR in the gastric cancer group were higher than those in benign lesion group and control group,and the difference was statistically significant(P < 0.05).3.The expression levels of CEA,CA19-9,CA72-4,and MG7 AG in the gastric cancer group were higher than those in benign lesion group and control group,and the expression level of PRG was lower than those in benign lesion group and control group,the differences were all statistically significant(P < 0.05).4.In combination test,the combined sensitivity and negative predictive values of CEA +CA19-9 + CA72-4 + MG7 AG + PGR were the highest,being 94.2% and 93.7%respectively,but the specificity and positive predictive values were the lowest,being63.6% and 65.8% respectively.CEA + CA19-9 + CA72-4 + MG7 AG combination had the highest accuracy rate,which is 83.6%.5.There were significant differences in CEA,CA19-9,CA72-4,MG7 AG,PGR positive rates and expression levels in patients with different TNM stages(P < 0.05),correlation analysis revealed that the expression levels of CA19-9,CA72-4,and MG7 AG were positively correlated with gastric cancer staging,and the correlation coefficients was 0.503,0.658,and 0.742 respectively.The correlation was statistically significant(P < 0.05).CEA and PGR expression levels were poorly correlated with gastric cancer staging,and the correlation was not statistically significant(P > 0.05).6.The corrected formula for calculation by analysis: F = ln(0.03 * A / 5 + 0.5* B / 37 + 0.065 * C / 3 + 0.75 * D / 8)-1,and A,B,C,D correspond to the expression levels ofCEA,CA19-9,CA72-4,MG7 AG respectively,which was used to predict the TNM stages of patients with gastric cancer.By calculation,the diagnostic agreement rate with actual stage of gastric cancer was 91.35%(95/104),which had a high consistency(Kappa = 0.853,P < 0.001).7.Immunohistochemical results showed that the positive expression rates of CEA and MG7 AG in gastric cancer group were obviously higher thanthat in benign lesion group and the control group,the differences were all statistically significant(P < 0.05).Conclusions 1.The positive rates of serum CEA,CA19-9,CA72-4,MG7 AG,and PGR in patients with gastric cancer are significantly higher than those in patients with intraepithelial neoplasia and normal mucosa,and they have the functions of auxiliary diagnosis and differential diagnosis.2.Among patients with gastric cancer,those with Hp infection and drinking history have higher MG7 AG and PGR positive rates.3.In the diagnosis of gastric cancer,the combined application of tumor markers is better than that of a single indicator,particularly the combination of CEA + CA199 + CA724 + MG7 AG is the best.4.The serum expression levels and positive rates of CEA,CA19-9,CA72-4,MG7 AG,and PGR are closely related to TNM staging in patients with gastric cancer,and these tumor markers can be used as important indicators to judge the prognosis of patients with gastric cancer.5.The calculation formula and reference range including CEA,CA19-9,CA72-4,and MG7 AG were initially drafted to predict the TNM stage of patients,and it has been verified that the consistency with the actual TNM stage was high. |
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