The Application And Value Of Measuring Serum CA72-4, CA19-9, CEA Standard In Cure Of Gastric Carcinoma

Objective :To evaluate the value of serum CA72-4, CA19-9, CEA standard in gastric cancer diagnosis through ROC curves and discriminant analysis. And, also to discover the application of serum tumor markers(TM) as well as its application in cure of gastric cancer and predicting prognosis through the way of analyzing the impact factors on TM standard.Method: Measure the serum CA72-4,CA19-9,CEA standard of85 cases in gastric cancer group and 146 cases in control group, then evaluate the case of using 3 kinds of TM separately and the case of using them together through ROC curves and discriminant analysis. And discover how to use 3 kinds of TM serum standard to diagnose gastric cancer. With the help of relations to the pathology of gastric cancer patients, analyze the impact factors of 3 serum TM standard and discover their applications in future cure of gastric cancer and predicting prognosis.Statistics: Use SPSS 17.0 and MedCalc software package to analyze the data. The adopted statistics algorithms are ROC curves, non-parametric rank sum test, discriminant analysis and correlation analysis.Result: The mean level of serum CA72-4, CA19-9 and CEA in gastric cancer group is higher than the ones in control group. Comparing using only CA72-4 to diagnose gastric cancer to using CA72-4, CA19-9 and CEA together to diagnose gastric cancer, their AUC value is 0.768 and 0.710 separately, there are no statistical difference between the two methods'AUC value. Both of the two methods are better than using only CA19-9 or CEA. By using the ROC curve, the cut-off value set to 1.65U/ml when using only CA72-4 to diagnose gastric cancer makes the Youden index value bigger, and in this case, indexes are: Se:61.18%, Sp:78.08%, Youden index: 0.393. The typical discriminant formula of using 3 kinds of TM together to diagnose gastric cancer is: D=0.015X1+0.011X2+0.081X3-0.597 (X1, X2 and X3 is the measurement of CA72-4, CA19-9 and CEA separately, if D>0, then the result could be predicted to be gastric cancer). And in this case, indexes are: Se: 35.3%, Sp: 95.90%. The serum level of CA72-4 or CA19-9 is in positive correlation with tumor invasion depth (T) as well as the metastasis extent of lymph node (N). Besides, CA72-4 also has relations to the differentiation of gastric cancer, types and distant metastasis. But CEA only has relations to distant metastasis. Using the correlation of 3 kinds of TM serum level and gastric cancer lymphatic metastasis,to predict whether the patients of gastric carcinoma have a lymphatic metastasis before operated, the typical discriminant formula is D=0.014X1+0.012X2+0.079X3-0.600 (X1,X2,X3 is the detecting value of CA72-4,CA199,CEA,if D>0,we can prognosticate that the patient has a lymphatic metastasis). In this case, indexes are: Se: 39.3%, Sp: 94.10%, accuracy rate: 51.3%. Conclusion: Both the way of using only CA72-4 to diagnose gastric cancer by cut-off value and the way of using 3 kinds of TM together to diagnose by measuring serum CA72-4, CA19-9 and CEA standard though discriminant fomula are having medium diagnostic value. To prognosticate patients having lymphatic metastasis or not before operation by discriminant fomula is a good clinical application of using the serum measured value of the 3 kinds of TM。...