| Background and Objective Stomach cancer is a global disease,the fifth most common cancer and the third leading cause of cancer death in the world.Its incidence is the result of a combination of multiple factors,mainly caused by genetic factors and environmental factors.China is a big country with gastric cancer,and the incidence of gastric cancer in China is characterized by a low proportion of early gastric cancer and a high proportion of locally advanced or advanced gastric cancer.In addition,the heterogeneity of gastric cancer also brings great difficulties to its treatment.The traditional treatment of gastric cancer in China is mainly surgical treatment,supplemented by postoperative radiotherapy and chemotherapy.However,under this treatment mode,the treatment of gastric cancer is too simple,and the proportion of locally advanced or advanced gastric cancer is too high,resulting in Chinese gastric cancer patients after surgery the overall prognosis is poor,so there is an urgent need for new treatments to improve the survival rate of gastric cancer patients.Neoadjuvant chemotherapy has gradually been widely used in clinical practice due to its unique advantages such as reduce tumor loading,degrade the staging,improving surgical R0 resection rate and prolonging the median survival of patients,and brings hope to gastric cancer patients.However,for gastric cancer patients receiving neoadjuvant chemotherapy,how to quickly and efficiently evaluate the efficacy of chemotherapy,so as to choose the appropriate timing of surgery,is particularly important.With the deepening of the understanding of tumors and the development of molecular biology,more and more efficient tumor markers are widely used in clinical practice.Glycosylation is one of the biochemical mechanisms that regulate cell function.Abnormal glycosylation of proteins occurs in almost all types of cancer.Tumor Abnormal Protein(TAP)is a type of abnormal glycoprotein produced in the process of carcinogenesis.It is closely related to cancer and has a large difference in content between tumor tissue and normal tissue.When the TAP content is high enough,it can be detected in the blood using special techniques.TAP detection combined with other auxiliary examinations is widely used in clinical practice,participating in the auxiliary diagnosis of tumors,the evaluation of the efficacy of tumor chemotherapy,the dynamic detection of tumor recurrence and metastasis,and the evaluation of prognosis.CA724(gastric cancer antigen)is one of the commonly used tumor markers for the diagnosis of gastric cancer.It has high specificity and sensitivity to gastric cancer.If combined with CA199 and CEA,it can monitor more than 70% of gastric cancer.It is widely used in the early screening of gastric cancer,clinical staging diagnosis,chemotherapy efficacy judgment and postoperative recurrence and metastasis monitoring.The article will study the relationship between the efficacy of neoadjuvant chemotherapy and the changes in serum tumor markers(TAP and CA724)in patients with locally advanced gastric cancer.Method A retrospective analysis of the medical records of 78 patients with locally advanced gastric(adeno)carcinoma diagnosed by imaging examination and endoscopic pathology from October 2018 to October 2020 in the Second Affiliated Hospital of Zhengzhou University and the Affiliated Tumor Hospital of Zhengzhou University(Gastric cancer group)and 60 cases of outpatient health checkups (healthy group)during the same period.Data: Record the basic medical records of the two study groups,such as age,gender,body mass index(BMI),etc.;record the serum TAP and CA724 values of the healthy group,record the serum TAP and CA724 values before and after chemotherapy in patients with gastric cancer,and record the CT image data before and after chemotherapy.The changes in CT images before and after chemotherapy were used to evaluate the efficacy of chemotherapy.According to the efficacy of chemotherapy,patients in the gastric cancer group were divided into chemotherapy effective and ineffective groups.Result(1)There was no statistically significant difference in the age,gender,body mass index(BMI)and other indicators of the two study groups(p>0.05);(2)The levels of serum TAP and CA724 before neoadjuvant chemotherapy in the gastric cancer patient group were significantly different from those in the healthy physical examination group(p<0.01);(3)The effective remission rate of neoadjuvant chemotherapy in patients with gastric cancer is 41.0%;(4)Before chemotherapy,there was no significant difference in serum TAP and CA724 levels between the chemotherapy effective group and the chemotherapy ineffective group(p>0.05);after chemotherapy,the serum TAP and CA724 levels of patients in the effective group were significantly lower than those in the ineffective group,and there was a difference between the two groups Statistically significant(p<0.05);the reduction of serum TAP and CA724 levels in the effective group was significantly higher than that in the ineffective group,and the difference between the two groups was statistically significant(p<0.05);(5)ROC curve analysis results indicate that the sensitivity,specificity and area under the curve of TAP combined with CA724 in evaluating the efficacy of neoadjuvant chemotherapy in locally advanced gastric cancer patients are significantly higher than those of TAP and CA724 alone(p<0.01).Higher assessment accuracy.Conclusion(1)The serum TAP and CA724 levels of patients in the gastric cancer group before chemotherapy were significantly higher than those in the healthy physical examination group,so the serum TAP and CA724 levels have certain value in gastric cancer screening;(2)The changes of serum TAP and CA724 levels before and after chemotherapy are significantly related to the efficacy of neoadjuvant chemotherapy in patients with gastric cancer,which can be used to evaluate the efficacy of neoadjuvant chemotherapy in patients with locally advanced gastric cancer,and the two have higher assessment accuracy when used in combination. |
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