| Objective:1.To study the adjuvant diagnosis value of the serum tumor markers(TM)of carcinoembryonic antigen (CEA), sialyl pentose fucose (CA19-9), gastrointestinal cancer antigen (CA242), alpha-fetoprotein (AFP), gastric cancer and ovarian cancer antigen (CA724), squamous cell carcinoma antigen (SCC), tissue polypeptide antigen (TPA), cytokeratin 18 (TPS) in the upper digestive tract tumors, include the gender, age, pathological type and clinical stage and the value of of combined detection of the serum tumor markers.2.To explore the correlation between the levels of serum tumor markers in the upper digestive tract cancer patients.3.To evaluat the value of surgical treatment through the detection of the serum levels of tumor markers in upper digestive tract cancer patients before surgery and post-operative.4.To explore the role of the serum tumor markers in the prognosis of the patients with upper gastrointestinal cancer.Methods:The patients with upper digestive tract cancer in Shanxi Cancer Hospital were included through 2004 to 2007 according to the different standard of each part of the study.The serum level of CEA,CA199,CA242,AFP,SCC,CA724,TPA,TPS were examined.The clinical reference of the patients such as gender, age, pathological type,clinical stage,treatment effects and postoperative follow-up were summarized and grouped. All the data were analyzed using the software package SPSS11.5.Results:1.The relationship between the serum tumor markers and gender, age: The 373 patients were grouped according to gender, male group (n=287), female group (n=86), AFP, SCC, TPA, TPS was no significant differences (P>0.05), the rest of the level of serum tumor markers are different.The patients were divided into 2 groups by age,groupI (<59 years old, n=188),groupII (>59 years old, n=185), there were no significant difference (P>0.05)between the groups of the serum level of each tumor marker except CEA.2.The correlation between the serum levelof CEA, CA242, CA199, CA724, AFP, SCC, TPA, TPS:Spearman correlation test showed that there exited negative correlation between the serum level of CEA, CA724, AFP, TPA, TPS, SCC with the correlation coefficient between 0.201-0.551,and a positive closely correlation between CA242 and CA199 ( correlation coefficient 0.810, P=0.0001).3.The serum level of 8tumor markers in the groups of upper gastrointestinal cancer and healthy control:the serum level of 8tumor markers of the group of upper gastrointestinal cancer increased significantly compared with that of the group of healthy control(P<0.001).4.Combined detection of tumor markers of clinical significance: CEA-positive rate of diagnosis of 26.80%, CA199-9 for 27.34%, CA242 to 34.14% AFP2.84%, SCC19.72%, CA724 to 12.13%, TPA was 34.15%, 30.89% for the TPS. The total positive rate of the Joint Inspection of 8 markers is 89.05%.5.The positive rate of 8 tumor markers in the different pathological types of upper gastrointestinal cancer: There were significant difference (P<0.05) between the different pathological types of the positive rate of each tumor marker except TPA and TPS.SCC have a higher positive rate in squamous cell carcinoma patients, CEA, CA242 and CA724 have a higher positive rate in patients with adenocarcinoma; other less tumors such as neuroendocrine tumors are not taken into account.6.The positive rate of 8 tumor markers at different stages of upper gastrointestinal cancer: Upper digestive tract cancer of serum tumor markers positive rate: CEA, CA242, CA199, CA724, AFP, SCC, TPA-positive rate increased with the rise in phases, the positive rates were significantly different (P<0.05) at different stages;TPS positive rate is no significant difference (P>0.05)at different stages;7.Compared with the serum level of 8tumor markers in the groups of preoperative and postoperative: CEA, CA199, CA242, AFP, SCC, CA724, TPA, TPS are undifferentiated (P>0.05).8.CA724, CA242, SCC survival curve: The survival time of patients with positive serum level was significantly lower than that patients with negative serumlevel.Conclusion:1.Eight of the tumor markers in upper gastrointestinal cancer has a different diagnosis value, the joint detection can improve their diagnostic value.2.The serum levels of tumor markers CA242 and CA199 were closely correlated in upper gastrointestinal cancer patients3.Radical surgery is far below the therapeutic purposes,for patients at stageII and more than stageII with preoperative positive serum levels of tumor markers in with,who need comprehensive treatment.4.CA724, CA242 and SCC 3 item can be marked as the cardia, stomach, esophagus indicators in patients with poor prognosis. |
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