背景:胃癌(GC)是消化系统常见的恶性肿瘤,恶性程度高。它通常在早期阶段阴险地发展而没有任何特定的症状。作为由基因异常改变引起的疾病之一,GC在其发育过程中具有各种癌基因和产物的异常表达。肿瘤标志物如癌胚抗原(CEA),糖抗原199(CA199)和糖抗原724(CA724)在正常人中不表达或低表达,但在致癌后显著增加。监测CEA等肿瘤标志物水平的变化,CA199和CA724有利于早期诊断和评估某些实体瘤的发生。
目的:研究CEA的表达,GC中CA199和CA724及其与临床特征的相关性,希望为GC的早期预防性诊断提供更有效的标志物。
方法:将我院2020年9月至2021年12月收治的87例GC患者纳入GC组,另选取同期来我院体检结果正常的健康体检者80例作为对照组。血清CEA,比较两组患者的CA199和CA724水平,和血清CEA,比较不同TNM分期的GC患者的CA199和CA724水平,以及CEA阳性率的差异,比较了CA199和CA724单独和联合检测GC和GC的TNM阶段。此外,肿瘤标志物CEA水平之间的关系,同时分析了CA199和CA724以及GC患者的临床病理特征。血清CEA水平,通过Pearson分析了CA199和CA724以及GC患者的生存期。
结果:血清CEA水平,GC组CA199、CA724明显高于对照组(P<0.05)。随着TNM分期的增加,血清CEA,CA199和CA724在GC患者中的表达水平显著升高,组间差异有统计学意义(P<0.05)。CA724单项试验阳性率高于CEA和CA199单项试验(P<0.05)。三项联合检测的阳性率为95.40%(83/87),高于CEA,CA199和CA724单项试验。差异有统计学意义(P<0.05)。CEA联合检测阳性率,CA199和CA724在第一阶段,II,III,GC的IV为89.66%,93.10%,98.85%,分别为100.00%和100.00%,所有这些都高于CEA的个体检出率,CA199和CA724。差异有统计学意义(P<0.05)。血清CEA无显著差异,不同性别GC患者之间的CA199和CA724水平,吸烟史和酒精史(P>0.05)。然而,血清CEA,CA199和CA724水平显著高于年龄≥45岁的GC患者,TNMIII-IV期,与年龄<45岁的GC患者相比,淋巴结转移和肿瘤直径≥5cm,TNMI-II期,无淋巴结转移,肿瘤直径<5cm(P<0.05)。
结论:血清肿瘤标志物CEA,GC患者的CA199和CA724均较高,并随TNM分期的增加而上升。CEA的水平,CA199和CA724与年龄有关,TNM阶段,淋巴结转移和肿瘤直径。CEA的联合检测,CA199和CA724有助于提高GC的诊断准确率,具有较高的临床指导价值。
BACKGROUND: Gastric cancer (GC) is a common malignant tumor of the digestive system with a high degree of malignancy. It usually develops insidiously without any specific symptoms in the early stages. As one of the diseases caused by abnormal gene changes, GC has abnormal expression of various oncogenes and products during its development. Tumor markers such as carcinoembryonic antigen (CEA), carbohydrate antigen 199 (CA199) and carbohydrate antigen 724 (CA724) are not expressed or lowly expressed in normal people, but significantly increased after carcinogenesis. Monitoring the changes in the levels of tumor markers such as CEA, CA199 and CA724 is conducive to early diagnosis and evaluation of the occurrence of some solid tumors.
OBJECTIVE: To investigate the expression of CEA, CA199 and CA724 in GC and their correlation with clinical features, hoping to provide more effective markers for the early preventive diagnosis of GC.
METHODS: Of 87 patients with GC admitted to our hospital from September 2020 to December 2021 were included in the GC group, and another 80 healthy people who came to our hospital for physical examination with normal results during the same period were selected as the control group. The serum CEA, CA199, and CA724 levels were compared between the two groups, and the serum CEA, CA199, and CA724 levels were compared in patients with GC at different TNM stages, and the differences in the positive rates of CEA, CA199, and CA724 alone and in combination in detecting TNM stages of GC and GC were compared. In addition, the relationship between the levels of tumor markers CEA, CA199 and CA724 and the clinicopathological characteristics of GC patients was also analyzed. The relationship between the serum levels of CEA, CA199 and CA724 and the survival period of GC patients was analyzed by Pearson.
RESULTS: The serum levels of CEA, CA199 and CA724 in GC group were significantly higher than those in control group (P < 0.05). With the increase of TNM stage, the serum CEA, CA199 and CA724 expression levels in GC patients increased significantly, and the differences between groups were statistically significant (P < 0.05). The positive rate of the CA724 single test was higher than that of CEA and CA199 single test (P < 0.05). The positive rate of the three combined tests was 95.40% (83/87), which was higher than that of CEA, CA199 and CA724 single tests. The difference was statistically significant (P < 0.05). The combined detection positive rates of CEA, CA199, and CA724 in stages I, II, III, and IV of GC were 89.66%, 93.10%, 98.85%, and 100.00% respectively, all of which were higher than the individual detection rates of CEA, CA199, and CA724. The differences were statistically significant (P < 0.05). There was no significant difference in serum CEA, CA199 and CA724 levels between GC patients with different genders, smoking history and alcohol history (P > 0.05). However, the serum CEA, CA199 and CA724 levels were significantly higher in GC patients aged ≥ 45 years, TNM stage III-IV, with lymph node metastasis and tumor diameter ≥ 5 cm than in GC patients aged < 45 years, TNM stage I-II, without lymph node metastasis and tumor diameter < 5 cm (P < 0.05).
CONCLUSIONS: The expression levels of serum tumor markers CEA, CA199 and CA724 in patients with GC are high and rise with the increase of TNM stage. The levels of CEA, CA199 and CA724 are related to age, TNM stage, lymph node metastasis and tumor diameter. The combined detection of CEA, CA199 and CA724 is helpful to improve the diagnostic accuracy of GC with high clinical guidance value.