| Purpose:Gastric cancer is the most common malignant gastrointestinal tumor. Early detection, early diagnosis of gastric cancer is important in gastric cancer prevention. Tumor Markers (Tumor Marker, TM) are the antigens or biological active substances abnormal generated by tumor tissue or cell, which in the normal tissue does not produce or produce very little. The results show that the same kind of tumor markers can exist in a variety of tumors, and different tumors can produce the same tumor markers. Seeking sensitive, specific markers of gastric cancer may be of significant value in clinical diagnosis of gastric cancer. Recent studies found that osteopontin (OPN) plays an important role in a variety of cancer development, and gastric cancer associated antigen(MG7-Ag) is higher sensitivity and strong specificity as markers of gastric cancer, tissue polypeptide specific antigen (TPS) can reflect the level of tumor cell proliferation and division in vivo activities. In this study, we detection the three tumor markers,OPN, MG7-AG, and TPS in the serum of gastric cancer patients, comparing with normal, benign lesions, precancerous lesions (including gastric dysplasia, intestinal metaplasia), evaluating the value of separate and combined detection of markers in gastric cancer diagnosis, discussion the role of the development and transfer of the possible molecular mechanism in order to improve the diagnosis of gastric cancer, and hope to supply a theoretical basis for molecular diagnostic methods in gastric cancer.Methods:We gathered the samples from the Third Affiliated Hospital of Nanchang University from November 2009 to June 2010,60 patients with gastric cancer, none of the patients accept any anti-cancer treatment before. Choose the control groups, including 20 patients in benign gastric lesions,24 patients in precancerous lesions, and 40 healthy volunteers. All benign and malignant cases were confirmed by endoscopy and (or) pathological diagnosis. Detect the exepression of serum OPN, MG7-Ag, TPS of all slected samples by enzyme-linked immunosorbent assay approach (enzyme linked immunosorbent assay, ELISA), we evaluate the sensitivity, specificity and the positive predictive value of individual and combined three markers examination in gastric cancer diagnosis, all date were analyzed by SPSS 17.0 analysis software by t-test, variance analysis and chi-square test.Results:1. The expression of serum OPN in Gastric cancer group was significantly higher than other groups (P<0.05), and there was statistical difference in tumor size, differentiation and distant metastasis, otherwise no significant difference in age, depth of invasion, lymph node metastasis or TNM stage (P>0.05), furthermore precancerous lesions and benign lesions showed no significant difference (P> 0.05).2. MG7-Ag expression had the tendency to increase in serum from the healthy group, benign gastric lesions, precancerous lesions to gastric cancer group(P<0.05), and it related to size, lymph node metastasis, distant metastasis, tumor stage and pathological differentiation degree(P<0.05).The sensitivity of diagnosis of gastric cancer was 78.3%, specificity was 88.1%, positive predictive value was 82.5%.3. TPS level in serum is higher in gastric cancer, and obvious statistical difference exist in distant metastasis(P<0.05), but no statistical difference in size, tumor differentiation, invasion depth, lymph node metastasis or tumor TNM stage (P>0.05), and the sensitivity of diagnosis of gastric cancer was 68.3%.4. MG7-Ag had the highest specificity (88.1%) in single detection, combined detection of serum OPN+MG7-Ag+TPS can significantly improve the sensitivity in diagnosis of gastric cancer(91.7%).Conclusion:1.The sensitivity, specificity and the positive predictive value of MG7-Ag were higher in diagnosis of gastric cancer, and we concluded it had important value for the early diagnosis of gastric cancer. MG7-Ag is an ideal tumor marker of gastric cancer.2. TPS level had correlation with tumor metastasis, and it had a certain significance in early diagnosis and prediction of cancer metastasis.3. Single detection of serum OPN may not have obvious value for the early diagnosis of gastric cancer.4. Combined detection of serum OPN, MG7-Ag and TPS can better improve the positive rate of diagnosis of gastric cancer, significantly better than the single indicator detect, and we consider that had a certain reference value for the clinical diagnosis of the gastric cancer. |
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