The application value of ten serum markers in diagnosis and treatment of gastric cancer

doi:10.3877/cma.j.issn.2095-5820.2022.04.008

Abstract

Abstract:

Objective

To investigate the diagnostic performance of ten serum markers of AFP, CEA, CA199, CA724, CA125, CA50, CA242 and PGⅠ, PGⅡ and PGR (PGⅠ/PGⅡ) in gastric cancer.

Methods

67 cases of gastric cancer patients in our hospital from August 2018 to February 2019 were selected as gastric cancer patients. All of the included cases were diagnosed with gastric cancer by gastroscopy and pathological tissue. According to whether sub-abdominal radical resection was performed, it was divided into 30 cases in the preoperative subgroup of gastric cancer and 37 cases in the postoperative subgroup of gastric cancer. In the same period, 30 cases with benign gastric disease were selected as gastritis group, and 20 cases of healthy physical examination were selected as healthy control group. AFP, CEA, CA199, CA724, CA125, CA50, CA242, PGⅠ, PGⅡ and PGR were detected, and the application value of these indicators in the diagnosis and treatment of gastric cancer.

Results

The concentration levels of CEA, CA199, CA724, CA125 and CA242 in the preoperative subgroup of gastric cancer were higher than those in healthy control group, gastritis group and postoperative gastric cancer subgroup (P＜0.05), and the levels of PGⅠ, PGⅡ and PGR were lower than those in the healthy control group and the gastritis group, the levels of PGⅠ, PGⅡ were higher than the postoperative subgroup of gastric cancer (P＜0.05). The levels of PGI and PGII in the postoperative subgroup of gastric cancer were lower than those in the healthy control group. The results of ROC curve analysis showed that the area under the combined diagnostic curves of PGⅠ, PGⅡ and PGR was 0.759. The area under the combined diagnostic curve of ten serum markers was 0.871.

Conclusions

CEA, CA199, CA724, CA125, CA242, PGⅠ, PGⅡ, PGR have certain clinical value in the diagnosis of gastric cancer and the differential diagnosis of benign and malignant tumors. PGⅠ, PGⅡ, PGR tests are useful for assessing and monitoring gastric mucosal function, The combination of PGⅠ, PGⅡ, PGR and ten serum markers have good diagnostic performance for the diagnosis of gastric cancer.

Key words: Gastric cancer, Pepsinogen, Serum markers

Jie Wei, Canping He. The application value of ten serum markers in diagnosis and treatment of gastric cancer[J]. Chinese Journal of Clinical Laboratory Management(Electronic Edition), 2022, 10(04): 233-237.

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Figures/Tables 2

References 20

1	Gao K, Wu J. National trend of gastric cancer mortality in China(2003-2015): A population-based study[J]. Cancer Commun(Lond), 2019, 39(1): 24.
2	中华人民共和国国家卫生健康委员会. 胃癌诊疗规范(2018年版)[EB/OL]. (2018-11-21) [2020-10-15]. URL
3	林莺莺, 陈燕, 胡敏华, 等. HE4、CA125和CA19-9单项和联合检测在子宫内膜癌诊断中的价值[J]. 临床检验杂志, 2014, 32(6): 471-473.
4	常彬霞, 辛绍杰. 甲胎蛋白及其临床应用研究进展[J]. 世界华人消化杂志, 2010, 18(6): 576-580.
5	周粼, 王欢, 梁道明, 等. 血清肿瘤标志物在胃癌术前评估的作用[J]. 中国普外基础与临床杂志, 2016, 23(4): 425-428.
6	刘兰凤, 田斌, 刘海燕, 等. 肿瘤标志物CEA、AFP、CA-199和CA72-4的检测在消化系统恶性肿瘤中的应用[J]. 国际检验医学杂志, 2017, 38(5): 596-597.
7	余志金, 陈惠新, 彭晓峰. 多种肿瘤标志物联合监测胃癌术后复发[J]. 现代临床医学, 2013, 39(5): 354-356.
8	魏善和, 闫丽妲, 邓芳, 等. 血清CEA、CA199、CA50、CA724联合检测对胃癌的临床意义[J]. 包头医学院学报, 2009, 25(5): 26-28.
9	Nilsson O, Johansson C, Glimelius B, et al. Sensitivity and specificity of CA242 in gastro-intestinal cancer. A comparison with CEA, CA50 and CA 19-9[J]. Br J Cancer, 1992, 65(2): 215-221.
10	甘建, 程荣贵, 王韶峰. 血清胃蛋白酶原对胃部疾病的诊断价值[J]. 世界华人消化杂志, 2018, 26(36): 2115-2119.
11	王思涵, 刘玉萍, 帅平, 等. 幽门螺杆菌联合胃蛋白酶原和胃泌素-17检测对健康体检人群胃癌前状态及胃癌筛查研究[J]. 中华肿瘤防治杂志, 2021, 28(14): 1056-1060.
12	董曲文, 陈晓, 丁纪元. 早期胃癌患者内镜黏膜下剥离术前后血清胃泌素-17、糖类抗原-125及胃蛋白酶原水平的变化和意义[J]. 中国内镜杂志, 2020, 26 (2): 37-42.
13	唐承薇. 胃黏膜内外分泌功能[J]. 中华消化杂志, 2021, 41(101): 9-12.
14	苗云峰, 刘兆东, 蔡慧. 术前血清肿瘤标志物糖类抗原125对胃癌腹膜转移诊断价值临床研究[J]. 临床军医杂志, 2018, 46(7): 794-795, 797.
15	康运凯, 吴学炜, 史小芹. 七项血清标志物在胃癌患者术前术后检测的临床意义[J]. 中华检验医学杂志, 2017, 40(1): 60-63.
16	刘智. 胃蛋白酶原的检测在胃癌筛查中的应用[J]. 临床检验杂志(电子版), 2019, 8(1): 9-10.
17	阳卫立, 杨荣萍, 罗永胜, 等. 七种肿瘤标志物联合检测在胃癌临床诊断中的应用[J].实用癌症杂志, 2018, 33(6): 887-891.
18	吴永伟, 赵刚. CEA、CA724、CA199与PGⅠ、PG Ⅱ、PGR联合检测在胃癌早期诊断中的价值分析[J]. 川北医学院学报, 2018, 33(6): 836-839.
19	Yoshihara M, Hiyarna T, Yoshida S, et al. Reduction in gastriccancer mortality by screening based on serum pepsinogen concentration: a case-control study[J]. Scand J Gastroenterol, 2007, 42(6): 760-764.
20	Ebule IA, Longdoh AN, Paloheimo IL. Helicobacter pylori infection and atrophic gastritis[J]. Afr Health Sci, 2013, 13(1): 112-117.

组别	例数	AFP（ng/ml）	CEA（ng/ml）	CA199（U/ml）	CA724（U/ml）	CA125（U/ml）
胃癌术前亚组	30	3.15（2.31，4.93）	4.20（1.28，16.15）^abc	17.55（5.53，31.75）^abc	3.45（0.88，8.03）^abc	13.00（10.08，30.8）^abc
胃癌术后亚组	37	2.71（1.86，4.12）	3.70（2.60，5.25）^a	13.1（7.90，21.70）^a	2.20（1.00，5.40）	10.90（8.60，17.35）
胃炎组	30	2.73（1.96，3.85）	2.15（1.45，3.40）	10.95（6.67，18.23）	2.00（0.98，4.83）	9.25（6.80，11.58）
健康对照组	20	3.23（2.50，4.18）	1.80（1.13，3.60）	8.50（5.13，14.35）	1.95（1.03，6.40）	9.40（8.13，12.03）
χ²值		0.859	11.410	13.328	10.096	10.915
P值		0.651	0.003	0.001	0.003	0.004
组别	例数	CA50（U/ml）	CA242（U/ml）	PGⅠ（U/ml）	PGⅡ（U/ml）	PGR
胃癌术前亚组	30	8.58（4.23，24.74）	7.87（1.65，17.27）^abc	22.12（12.80，33.10）^abc	10.05（7.08，13.84）^abc	3.29（3.00，6.30）^ab
胃癌术后亚组	37	7.98（5.31，14.19）	4.32（3.00，8.84）	9.65（5.6，17.42）^ab	2.76（1.93，4.03）^ab	3.00（2.50，5.00）^ab
胃炎组	30	7.78（4.85，11.58）	3.49（2.57，8.77）	63.68（46.96，84.62）	11.04（6.98，15.93）	6.00（5.00，8.00）
健康对照组	20	6.04（4.43，8.31）	3.36（1.84，8.69）	61.32（40.66，72.36）	12.13（7.18，17.89）	5.00（4.00，6.00）
χ²值		3.034	11.460	15.964	14.727	15.011
P值		0.219	0.002	0.000	0.000	0.001

组别	例数	AFP（ng/ml）	CEA（ng/ml）	CA199（U/ml）	CA724（U/ml）	CA125（U/ml）
胃癌术前亚组	30	3.15（2.31，4.93）	4.20（1.28，16.15）^abc	17.55（5.53，31.75）^abc	3.45（0.88，8.03）^abc	13.00（10.08，30.8）^abc
胃癌术后亚组	37	2.71（1.86，4.12）	3.70（2.60，5.25）^a	13.1（7.90，21.70）^a	2.20（1.00，5.40）	10.90（8.60，17.35）
胃炎组	30	2.73（1.96，3.85）	2.15（1.45，3.40）	10.95（6.67，18.23）	2.00（0.98，4.83）	9.25（6.80，11.58）
健康对照组	20	3.23（2.50，4.18）	1.80（1.13，3.60）	8.50（5.13，14.35）	1.95（1.03，6.40）	9.40（8.13，12.03）
χ²值		0.859	11.410	13.328	10.096	10.915
P值		0.651	0.003	0.001	0.003	0.004
组别	例数	CA50（U/ml）	CA242（U/ml）	PGⅠ（U/ml）	PGⅡ（U/ml）	PGR
胃癌术前亚组	30	8.58（4.23，24.74）	7.87（1.65，17.27）^abc	22.12（12.80，33.10）^abc	10.05（7.08，13.84）^abc	3.29（3.00，6.30）^ab
胃癌术后亚组	37	7.98（5.31，14.19）	4.32（3.00，8.84）	9.65（5.6，17.42）^ab	2.76（1.93，4.03）^ab	3.00（2.50，5.00）^ab
胃炎组	30	7.78（4.85，11.58）	3.49（2.57，8.77）	63.68（46.96，84.62）	11.04（6.98，15.93）	6.00（5.00，8.00）
健康对照组	20	6.04（4.43，8.31）	3.36（1.84，8.69）	61.32（40.66，72.36）	12.13（7.18，17.89）	5.00（4.00，6.00）
χ²值		3.034	11.460	15.964	14.727	15.011
P值		0.219	0.002	0.000	0.000	0.001

血清标志物	AUC	敏感性（%）	特异性（%）
AFP	0.531	52.3	49.6
CEA	0.704^a	73.1	65.0
CA199	0.598^a	47.4	50.9
CA724	0.621^a	69.5	52.4
CA125	0.655^a	59.7	70.0
CA50	0.552	39.6	62.3
CA242	0.676^a	59.8	63.6
PGI	0.739^a	62.7	92.0
PGⅡ	0.726^a	58.2	92.0
PGR	0.703^a	34.3	85.0
PGI+PGⅡ+PGR	0.759^a	62.7	95.0
十项联合指标	0.871^a	73.1	90.0

血清标志物	AUC	敏感性（%）	特异性（%）
AFP	0.531	52.3	49.6
CEA	0.704^a	73.1	65.0
CA199	0.598^a	47.4	50.9
CA724	0.621^a	69.5	52.4
CA125	0.655^a	59.7	70.0
CA50	0.552	39.6	62.3
CA242	0.676^a	59.8	63.6
PGI	0.739^a	62.7	92.0
PGⅡ	0.726^a	58.2	92.0
PGR	0.703^a	34.3	85.0
PGI+PGⅡ+PGR	0.759^a	62.7	95.0
十项联合指标	0.871^a	73.1	90.0

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