Detection And Clinical Significance Of CEA And CK19 In Stage Ⅲ Gastric Cancer

Objective:The positive expression of CEA and CK19 in serum and peritoneal lavage fluid of patients with stage III gastric cancer was detected by various methods,and to find a method to increase the positive rate of exfoliated cancer cells in abdominal cavity by using correlation statistical analysis.Materials and Methods:From October 2015 to October 2016,112 patients with stage Ⅲ gastric cancer were selected as experimental group in the first Hospital of Jilin University.25 patients with gastric ulcer or gastric benign tumor were selected as control group.Serum was collected from patients before operation.The first time peritoneal lavage fluid(control group and experimental group)were collected before operation,if the original ascites were directly sucked out,and the second(experimental group before abdominal closure)peritoneal lavage fluid.Each time about 300-500 ml.One of the peritoneal lavage fluid taken about 200 ml to detect the expression of CEAmRNA and CK19 m RNA,the remaining peritoneal lavage solution which was used to detect the traditional exfoliative cytology,tumor markers and immunohistochemical methods.The celiac lavage fluid of the second time was detected by qRT-PCR method,and the pathological information of the patient was collected.Results:In this study,the results of traditional exfoliative cytology in 25 cases of non-gastric cancer in the control group were all negative.The positive rate of CEA immunohistochemistry in peritoneal lavage fluid was 12%,the positive rate of traditional exfoliative cytology in the first abdominal lavage fluid of 112 patients with gastric cancer was 14.29% and the positive rate of CEA immunohistochemistry was42.86%,the positive rate was significantly different between the two groups(P <0.001),and the results were consistent with each other(P < 0.001).These 96 patients with traditional exfoliative cell negative in the experimental group,the positive rate of CEAmRNA in the first peritoneal lavage fluid was higher than the positive rate of CEA that in serum and peritoneal lavage fluid(P < 0.05),and the positive rate of CK19 m RNA in peritoneal lavage fluid was higher than that in serum CK19(P <0.001).The positive rate of at least one positive group was higher than that of serum CEA and CK19,and the difference was statistically significant(P < 0.05).The area of CEAmRNA ROC curve was 0.698(P < 0.05),which had diagnostic value.The area of CEA ROC curve in serum and peritoneal lavage fluid was more than 0.5(P > 0.5),but there was no statistical significance.The area of serum CK19 ROC curve was0.511,the area of CK19 mRNA ROC curve in peritoneal lavage fluid was 0.611,but both P > 0.05,there was no statistical significance.The area is 0.660(P < 0.05),which is statistically significant.In conclusion,compared with other methods,the detection of CEA mRNA has higher sensitivity,specificity and diagnostic ability.While the area of ROC curve of CK19 mRNA is 0.611(P > 0.05),but its sensitivity and specificity are higher than that of other methods,therefore also has certain clinical diagnosis value.The Ct number of CEAmRNA and CK19 mRNA in the first peritoneal lavage fluid of 112 patients in the experimental group was significantly different in the depth of tumor invasion(T3、T4 > T1、T2)and lymph node metastasis(yes > no)(P < 0.05).There was no significant difference in the positive rate and the Ct number of CEAmRNA and CK19 mRNA between the two celiac washings in the experimental group(P > 0.5).Conclusions:1.The expression of CEAm RNA and CK19 mRNA in peritoneal lavage fluid of gastric cancer patients was detected by qRT-PCR,the positive rate of exfoliated cancer cells in abdominal cavity could be increased.2.With the increase of tumor invasion depth and lymph node metastasis in gastric cancer patients,the value of 2^(-△△Ct target gene)is statistically different.(P< 0.05).