| Objective:To evaluate the value of combined detection of Septin9 and serum glycoprotein tumor markers for diagnosis and prognosis evaluation of gastric cancerMethods:Sixty patients with gastric cancer who concurrent radical gastrectomy at the hospital of Anhui and forty patientshad negative endoscopic performance were selected as normal control group during August 2017 to February 2018.The electro-chemicalluminescence was applied to detect the levels of serum tumor makers CEA,CA19-9,CA72-4 of 100 patients.The immuno-histochemistry was used to determine the levels of Septin9 protein expression in gastric cancer tissues and adjacent tissues of 60 patients with gastric cancer.The general data and pathological data were collected and organized,60 patients with gastric cancer were followed up for 24 months after surgery.We compared the levels of Septin9 protein expression in gastric cancer tissues with that of corresponding para-cancer tissues as well as the levels of Septin9 protein expression in tissues of patients with different clinical stages of gastric cancer The correlation between the levels of Septin9 protein in tumor tissues and clinicopathological features were reviewed.We compared the levels of serum glycoprotein tumor markers in gastric cancer patients with that of normal controls.ROC curve was applied to analyze and compare the sensitivity,specificity of each tumor marker,tissue Septin9 and tumor markers combined with tissue Septin9 for the diagnosis of gastric cancer.Survival curve analysis compared the value of each tumor marker,tissue Septin9 and tumor marker combined with tissue Septin9 for prognosis evaluation of gastric cancerResults:The positive expression rate of Septin9 in gastric cancer tissues was higher than that in adjacent tissues(85.0%vs.36.7%),with statistically significant difference(P<0.05).The levels of Septin9 protein expression were different in patients with different stages of gastric cancer.The high expression rate of Septin9 in clinical stage ?,IV group was higher than that in stage ?,? group(84.6%vs.19.0%),the high expression rate of Septin9 in patients with tumor diameter>5cm was higher than that in tumor diameter ?5cm group(71.4%vs.16.7%,P<0.05),the high expression rate of Septin9 in lowly differentiated GC group was higher than that in moderately and highly differentiated GC group(89.2%vs.39.1%,P<0.05),the high expression rate of Septin9 in the depth of infiltration(T3,T4)group was higher than that in the depth of infiltration(T1,T2)group(69.8%vs.29.4%,P<0.05),the high expression rate of Septin9 in patients with lymph node metastasis was higher than that in no lymph node metastasis group(80.6%vs.50%,P<0.05).The serum CEA level of gastric cancer patients was much higher than that of the normal control group while the serum CA19-9 and CA72-4 levels of gastric cancer patients were not significantly different with the normal control group(P>0.05).Among the three glycoprotein tumor markers,CEA was the best diagnostic indicator for gastric cancer because of the highest sensitivity(60.78%vs 55.03%vs 58.14%,P<0.05)and specificity(66.32%vs 55.97%vs 57.53%,P<0.05)for the diagnosis of gastric cancer.For the diagnosis of gastric cancer,the sensitivity and specificity of Septin9 were 59.48%,60.83%,respectively.When combined two indicators above,the sensitivity and specificity of for the diagnosis of gastric cancer rise to 70.02%,71.31,respectively.The ROC curve analysis indicated that AUC of CEA,Septin9,combination of the two indicators were 0.765,0.804,0.916 in the diagnosis of gastric cancer.The median progression-free survival years of the CEA low expression group were significantly higher than those of the CEA high expression group(23.0 months vs 17.4 months,P=0.000);the progression-free median survival years of the Septin9 low expression group were significantly higher than those of the high expression group of Septin9(23.7 months vs 20.7 months,P=0.001);the median survival time of the groups with high and low expression of Septin9 and CEA were 18.1 months and 23.7 months,with statistically difference(P=0.000)Discussion:The positive expression rate of Septin9 in gastric cancer tissues was significant higher than that in para-cancer normal tissues.The expression rate of Septin9 in tissues was closely related with tumor staging,tumor diameter,depth of infiltration,differentiated degree and lymphatic metastasis.Among the three glycoprotein tumor makers,CEA has the highest efficiency for diagnosis and prognosis evaluation of gastric cancer.The combination of detection of Septin9 in tissue and serum glycoprotein tumor markers can effectively improve the sensitivity and specificity of gastric cancer diagnosis,it also provides important value for prognosis evaluation of gastric cancer.In addition,Septin9 may be a potential molecular marker for the diagnosis and treatment of gastric cancer. |
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