| Objective To investigate the relationship between tumor marker(CA199,CEA,AFP,CA125,CA153)as well as immunohistochemical biomarkers(Ki-67,P21,P53,CEA,CK)and the biological characteristics of gastric cancer,and to determine the value of metastasis and prognosis of gastric cancer.According to the follow-up study,analyze the postoperative survival timeMethods According to the inclusion criteria and exclusion criteria,we retrospectively collected 385 concurrent patients with gastric cancer during April 2013 to April 2018,including 342 cases without peritoneal metastasis and43 cases with peritoneal metastasis.Independent sample T test was used to compare the level of tumor markers between peritoneal metastasis group and non-peritoneal metastasis group,and to evaluate whether there was a relationship between serum tumor marker level and peritoneal metastasis.The Chi-square test was used to compare the immunohistochemical biomarkers in peritoneal metastasis group and non-peritoneal metastasis group,and to analyze the relationship between the expression of immunohistochemical biomarkers and peritoneal metastasis.ROC curve method was used to evaluate thesensitivity and specificity of tumor markers to peritoneal metastasis,and to evaluate its predictive efficacy for peritoneal metastasis.After the tumor markers and immunohistochemistry biomarkers were divided into high and low expression level according to the negative or median value method,using Kaplan-Meier curve to determine whether there was correlation between the expression level and the survival time of the patients.And to determine whether they could be used as prognostic factors.Results The independent sample t test showed that the preoperative serum CA125,CEA concentration in the peritoneal metastasis group was higher than that in the non-peritoneal metastasis group,and it could be concluded that there was a difference in preoperative serum CA125,CEA level between the two groups(P < 0.05).There was no difference in serum CA199,CA153,AFP concentration between the two groups before operation(P > 0.05).There was no significant difference in the expression of CEA,CK,KI-67,P21,P53 between the two groups(P > 0.05).The results of Chi-square test showed that the serum CA199,CEA,AFP level in patients over 60 years old was higher than that in patients under 60 years old.The serum CEA level in male patients was higher than that in female patients before operation.Whether the serum CA125,CA153 concentration increased or not was not related to the location of the tumor,age and sex(P > 0.05).ROC curve showed that the increase of serum CA199,CA125,CEA had certain reference value in predicting peritoneal metastasis of gastric cancer(P < 0.05),and the accuracy of serum CA125 in predicting peritoneal metastasis of gastric cancer was the highest.The increase of AFP had no statistical significance in predicting peritoneal metastasis(P > 0.05).The Kaplain-Meier curve showed that the postoperative survival time of the elevated serum CA199,CEA group was shorter than that of the normal serum CA199,CEA group(P < 0.05).There was no significant difference in the postoperative survival time between the two groups(P > 0.05).There was no significant difference in the expression of P21,P53,CEA,Ki,67 and CK between the two groups in postoperative survival time(P > 0.05).Conclusion The preoperative serum CA125,CEA level in peritoneal metastasis group was higher than that in non-peritoneal metastasis group(P <0.05).The increase of CA199,CA125,CEA had certain reference value in predicting peritoneal metastasis of gastric cancer(P < 0.05).The patients with CA199 and CEA positive had a poor prognosis.The expression levels of P21,P53,CEA,KI-67 and CK were not significantly different between peritoneal metastasis group and non-peritoneal metastasis group,and had little significance in predicting the prognosis of the patients. |
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