The Clinical Value Of Serum CA125 In The Diagnosis Of Peritoneal Metastasis Of Gastric Cancer

Objective:The purpose of this study was to investigate the clinical value of preoperative serum CA125 in the diagnosis of peritoneal metastasis in gastric cancer,as well as the diagnostic value of combined CEA,CA199,CA242 and AFP detection,so as to provide basis for the diagnosis,efficacy monitoring and prognosis assessment of peritoneal metastasis in gastric cancer.Methods:Data of this study were collected from patients who underwent gastric cancer surgery in China-Japan Friendship Hospital of Jilin University from January 2019 to October 2020.A total of 188 patients were collected according to inclusion criteria and exclusion criteria.Patients were divided into gastric cancer group with peritoneal metastasis and group without peritoneal metastasis according to whether peritoneal metastasis occurred.Among them,38 patients were in the group of gastric cancer with peritoneal metastasis,and 150 patients were in the group without peritoneal metastasis.Serum tumor marker levels and other clinicopathological data were collected on the second day after admission.The levels of tumor markers in patients with gastric cancer with peritoneal metastasis and patients without peritoneal metastasis were compared,represented by median and quartile,and the difference test was performed by nonparametric test(Mann-Whitney U test).Chi-square test was used to analyze and investigate the correlation between clinical pathological data and preoperative tumor markers and peritoneal metastasis of gastric cancer.Multivariate Logistic regression analysis was performed on the factors with significant statistical significance,so as to determine the independent risk factors for peritoneal metastasis of gastric cancer.Receivers operating characteristic(ROC)curve was used for analysis,and the AUC under the ROC curve was calculated to evaluate its predictive efficacy in peritoneal metastasis of gastric cancer.Results:1.In this study,the preoperative levels of 5 kinds of serum tumor markers in the gastric cancer group with peritoneal metastasis were significantly higher than those in the group without peritoneal metastasis,and the differences were statistically significant(P<0.05).2.The chi-square test was performed on the clinicopathological data and preoperative serum tumor markers of the patients,and the results showed that there was no statistical significance between the two groups in age,gender,tumor site and tumor maximum diameter(P>0.05).The differences of surgical methods,tumor differentiation degree,clinical stage,CA125,CA199,CA242,CEA,AFP and ascites between gastric cancer group with peritoneal metastasis and the group without peritoneal metastasis were statistically significant(P<0.05).Multivariate Logistic regression analysis of statistically significant indicators showed that ascites(OR =8.880,P =0.001)and CA125(OR =16.063,P =0.003)were independent risk factors for peritoneal metastasis of gastric cancer.3.The results showed that tumor location,tumor maximum diameter,degree of differentiation,clinical stage,degree of peritoneal metastasis and presence of ascites had influence on CA125 level(P>0.05),while age and sex had no significant correlation on CA125 level(P >0.05).4.Preoperative analysis of the diagnostic value of serum tumor markers and ascites in peritoneal metastasis of gastric cancer showed that serum CA125 had the highest value in the diagnosis of peritoneal metastasis of gastric cancer(AUC= 0.964),while AFP had the lowest value in the diagnosis of peritoneal metastasis of gastric cancer(AUC=0.496).The diagnostic value of the combination of all tumor markers was higher than that of any single tumor marker.CA125 combined with ascites had high diagnostic value for peritoneal metastasis of gastric cancer(AUC=0.977).Conclusions:1.In this study,the preoperative serum tumor marker level of patients with gastric cancer with peritoneal metastasis was higher than that of patients without peritoneal metastasis,with statistical significance(P<0.05).2.Preoperative serum CA125 level is helpful to predict peritoneal metastasis of gastric cancer,and the combined detection of tumor markers can improve the clinical diagnostic value of peritoneal metastasis of gastric cancer.3.CA125 and ascites are independent risk factors for peritoneal metastasis of gastric cancer,and their combined detection is helpful to improve the prediction efficiency of peritoneal metastasis of gastric cancer.