Clinical Significance Of Monitoring Preoperative CEA, CA125, CA19-9 And β HCG Serum Level In Esophageal Cancer

BackgroundEsophageal carcinoma is a kind of malignant highest gastrointestinal cancer, mortality in the sixth malignant tumor. Incidence rate is the first place in China's rural areas, and the annual incidence rate is still increasing. After surgical treatment of early esophageal carcinoma 5-year survival up to 70%, while the prognosis of patients with advanced esophageal cancer remains poor,5-year survival rate at between 10-13%.Although the diagnosis and treatment advances, the early clinical symptoms are not obvious and over 90%of esophageal cancer at the time of diagnosis still has advanced, so the key to the treatment of esophageal cancer is early detection, early diagnosis and early treatment. Currently, the mainly treatment of esophageal carcinoma is by surgical combination with chemotherapy and radiotherapy. The influence factors of esophageal patients survival time of post-esophagectomy lies in the surgery effects and whether appears metastasis and recurrence. Therefore, it needs high sensitivity to the diagnosis method to assist clinical judgment and surgical patients with esophageal cancer metastasis and recurrence, whether the directly related to the survival time of patients. At present although the type of tumor markers has reached hundreds of species, but still no ideal tumor markers can be used for the clinical diagnosis and prognosis of esophageal cancer as an indicator. Therefore, how to search the molecular techniques can be used to improve the detection rate and monitoring of esophageal cancer surgery efficacy and early postoperative judgment metastasis and recurrence has become a major clinical and basic research direction. The rapid development of molecular biology, detection technology progress, and tumor markers were used for us to better inchoate discovery, monitoring of esophageal cancer prognosis, improvement and choose appropriate treatment methods and to improve the survival rate.ObjectiveTo explore the value of monitoring the perioperative period esophageal patient's CA125 CA19-9 CEA, andβHCG serum levels and the dynamic changes in patients with surgical treatment.Methods50 clinical data of esophageal carcinoma in our hospital from May 2009 to October 2009 were analyzed,50 cases of squamous cell carcinoma were diagnosed by pathology after surgery, including 36 males,14 female, and age between 42 and 76 years old(mean age 60.68±8.23 years old). According to the TNM clinical stages is divided into five groups:phaseⅠgroup 3 cases,Ⅱa group 9 cases,Ⅱb group17 cases,Ⅲgroup 21 cases,Ⅳgroup 0 cases. According to the high, medium and low differentiation degree is divided into three groups:well-differentiated groups 15 cases, medium differentiation groups 28 cases, low differentiation groups 7 cases. According to the course is divided into four groups:preoperative group,1 week after operation group,1 month after operation group and 3 months after operation group. 10 clinical data of physical health check in our hospital from May 2009 to October 2009 were analyzed as control group (normal), including 7 males,3 female, and age between 38 and 65 years old(mean age 53.48±7.69 years old). Fasting blood 4ml was collected from normal group and patient preoperative group,1 week after operation group,1 month after operation group,3 months after operation group. Chemical luminescence immunoassay was used to determinate the CEA, CA125, CA19-9 andβHCG serum level.ResultsThe preoperative CEA, CA125 and CA19-9 serum level of esophageal cancer were significantly higher than the control group, the difference was statistically significant(P<0.01).The preoperativeβHCG serum levels and the normal group had no significant difference (P> 0.05). The CEA, CA125 and CA19-9 serum level of esophageal cancer after surgery 1 week group,1 month group and after 3 months group, were significantly higher than the preoperative group, the difference was statistically significant(P<0.05). TheβHCG serum level of esophageal cancer after surgery 1 week group,1 month group and after 3 months group, were not significantly different with the preoperative group (P>0.05). The CEA, CA125 and CA19-9 serum level of esophageal cancer after surgery 1 month group, after 3 months group and normal group had no significant difference (P>0.05). The preoperative CEA, CA125 and CA19-9 serum level of esophageal cancer were positively correlated with preoperative clinical stages (P<0.05). The preoperative CEA, CA125 and CA19-9 serum level of esophageal cancer were not significantly different with tumor differentiation degree (P>0.05). The single positive rate of CEA, CA125 and CA19-9 was 24%.36%.16%respectively, the joint detection of CEA CA125 CA19-9 compared with single detection rate was statistically significant (P< 0.01).Conclusions1.Dynamic monitoring of perioperative CEA, CA125 and CA19-9 serum levels in esophageal cancer can be used as monitoring indicators for clinical surgery, monitoring index has certain reference value.2. The CEA CA125 and CA19-9 serum level of esophageal cancer was positively correlated with clinical stage. The tumor was later, the serum level was higher.3. The preoperative CEA, CA125, and CA19-9 serum level was not related to the differentiation of esophageal cancer.4. TheβHCG serum level as a tumor marker detection has little significance in esophageal cancer.5. The single target detection of CEA, CA125, and CA19-9 serum level of esophageal cancer is better than the joint detection. The CA19-9 in esophageal cancer detection is the best, followed by CEA, the last is the CA125, the three joint detection rate increased to 58%.The joint detection of CEA, CA125 and CA19-9 serum level of esophageal cancer can be used for diagnosis and prognosis.