Detection And Diagnostic Significance Of Serum Tumor Markers In Patients With Gastric Cancer

Objective To investigate the diagnostic value of serum tumor markers carcinoembryonic antigen(CEA),carbohydrate antigen 199(CA199),carbohydrate antigen 242(CA242),pepsinogen Ⅰ(PG Ⅰ)and pepsinogen Ⅱ(PG Ⅱ)in gastric cancer(GC).Methods The clinical data of 561 patients which suspected GC in our hospital from January 2017 to January 2020 were retrospectively analyzed.All patients were detected for the expression levels of serum tumor markers CEA,CA199,CA242,PG Ⅰ,and PG Ⅱ by ELISA.Using gastroscope based histopathological results as gold standard,the evaluation of 5serum tumor markers in patients with suspected GC was analyzed;and the relationship between their expression levels and clinicopathological parameters of patients with GC was analyzed;The ROC curve was used to analyze the value of serum CEA,CA199,CA242,PG Ⅰ,PG Ⅱ in the diagnosis of GC.Results Among 561 patients with suspected GC,histopathological diagnosis showed that 279 cases had GC and 282 cases had benign gastric lesions.Serum levels of CEA,CA199,CA242,and PG Ⅱ in GC group were significantly higher than those in gastric benign lesion group(P<0.05),and serum PG Ⅰ level was significantly lower than which in gastric benign lesion group(P<0.05).The expression levels of serum tumor markers CEA,CA199,CA242,PG Ⅰ and PG Ⅱ are not related to ages,genders and tumor sites of GC patients(P>0.05).The serum levels of CEA,CA199,CA242,and PG Ⅱ in GC patients with tumors ≥5cm were significantly higher than those in patients with tumors less than 5 cm(P<0.05),and PG Ⅰ level was significantly lower than those in patients with tumors less than 5cm(P<0.05).There were significant differences in serum CA199,CA242,and PG Ⅰ levels among GC patients with different differentiation degrees(P<0.05);the serum CEA and PG Ⅱlevels were no significant difference in patients with low,medium and well differentiated gastric cancer(P>0.05).Serum levels of CEA,CA199,CA242,and PG Ⅱ in patients with stage Ⅲ+Ⅳ GC were significantly higher than those with stage Ⅰ+Ⅱ GC(P<0.05),and the level of PG Ⅰwas significantly lower than those with stage Ⅰ+Ⅱ GC(P<0.05).The accuracy of serum CEA,CA199,CA242,PG Ⅰ,PG Ⅱ individually used to assist in the diagnosis of GC were 53.65%,53.65%,45.81%,67.56%,and 56.15%,respectively.In the combined detection of three markers,CEA+PG Ⅰ+PG II had the highest accuracy,and CEA+CA199+CA242 had the lowest accuracy,being 73.80% and67.38%,respectively;In the combined detection of four markers,CEA+CA242+PG Ⅰ+PG Ⅱ had the highest accuracy,and CEA+CA199+CA242+PG Ⅱ had the lowest accuracy,being 82.53% and77.72%;The accuracy was the highest in the combined detection of CEA,CA199,CA242,PG Ⅰ and PG Ⅱ in the diagnosis of GC,which was88.06%.In the single detection,the AUC of serum CEA,CA199,CA242,PG Ⅰ and PG Ⅱ in the assisted diagnosis of GC were 0.536,0.536,0.458,0.676 and 0.562,respectively;In the combined detection of three markers,CEA+PG Ⅰ+PG II had the highest AUC,being 0.738;In the combined detection of four markers,CEA+CA242+PG Ⅰ+PG Ⅱ had the highest AUC,being 0.825;The combined detection of CEA,CA199,CA242,PG Ⅰ and PG Ⅱ in the diagnosis of GC has the highest AUC,which was 0.881.Conclusions Tumor markers CEA,CA199,CA242,PG Ⅰ and PG Ⅱ expression levels are related to tumor size,differentiation and clinical stage of GC patients.The combined detection of tumor markers can significantly improve the sensitivity and detection rate of GC diagnosis,which has high clinical diagnostic value assistly.