The Study Of OPN Combined With CK18, CEA, CA72-4, And CA19-9in Diagnosis Of Gastric Cancer And Pathology Of TNM Stages

Objective: To evaluate the concentration of osteopontin (OPN) in theserum of patients with gastric cancer. Combined with CK18, CEA, CA72-4andCA19-9of tumor markers in the serum to detected the clinical diagnosis ofgastric cancer earlier and diagnosis of benign and malignant gastric lesions andtheir biological behavior, such as histological type, TNM stages and lymphnode metastasis, using receiver operating characteristic curve (ROC) to find outthe sensitivity and specificity of these five kinds of tumor markers, and to selecta perfect experimental combinations in the diagnosis of early gastric cancer.Materials and Methods: Select the pathologically confirmed120cases ofgastric cancer patients for the experimental group,27cases of benign gastricdisease and20healthy subjects, respectively, for the two control groups.Measured by ELISA serum OPN in the content, chemiluminescence wasdetected in serum CK18content,electrochemiluminescence detected in serumof CEA, CA72-4, and CA19-9levels. Drawn based on the ROC curve,obtained five tumor markers in serological differential diagnosis of benign andmalignant gastric the threshold, the diagnostic yield, sensitivity, specificity.Measurement data, depending on the type of data distribution, the Wilcoxontest was used to count data using χ2test.Results:(1) OPN in gastric cancer group mean of44.96±18.33(μg/L) wassignificantly higher than the medical group35.74±8.58(μg/L) and benignlesions31.19±13.15(μg/L), three sets of differences have statisticalsignificance (P<0.05), the benign lesion group than in both the medical group difference was statistically significant (P<0.05).(2) The combined detection of four tumor markers CA19-9, CA72-4, CEA,CK18, the mean is31.29±50.95(U/ml),21.54±56.34(U/ml),15.91±50.43(ng/ml,),10.87±15.35(mU/mL) were higher than their ownbiological reference interval, markers of gastric cancer group was significantlyhigher than the benign group and medical group, a statistically significantdifference (P<0.05).(3) The area under the ROC curve of five tumor markers of OPN up to0.795, the other four were of CA72-4(0.779)> CEA (0.673)> CK18(0.659)>CA19-9(0.566). Pairwise union OPN+CK18, the diagnostic sensitivity of upto73.3%; three combinations of sensitivity was significantly higher in the OPN+CK18+CA72-4sensitivity of up to80.7%, four joint detection of the OPN+CEA+CA72-4+CA19-9sensitivity of84.2%; five joint detection with highspecificity, but sensitivity decreased to79.2%.(4) Accoding to the ROC curve to identify malignant gastric by the OPN,CA19-9, CA72-4, CEA, CK18, Clinical Laboratory diagnostics critical point,respectively:39.9μg/L,22.9U/ml,5.19U/ml,3.41ng/ml,6.1mU/mL.(5) In gastric cancer, the positive rate of five tumor markers OPN up to51.7%, the level of the other four positive rate of followed by CA72-4(49.2%)> CK18(43.3%)> CEA (38.3%)> CA19-9(30.8%).(6) The relationship of OPN and TNM: OPN in stage III, IV patients,tumor marker concentrations is higher than stage I, II, the difference wasstatistically significant (P<0.05); OPN concentration in the lymph nodemetastasis is higher than the patients without metastasis, the difference wasstatistically significant (P<0.05).Conclusion:(1) The concentration of OPN in the serum of gastric cancer is higher thanthe benign group and normal group which can be used as one of the clinical examination for early diagnosis of gastric cancer indicators and also can beused as a clinical examination one of the indicators to identify the stomach ofbenign and malignant lesions.(2) In the diagnosis of gastric cancer, OPN positive diagnosis rate is higherthan the CK18, CEA, CA72-4, CA19-9can be used as the preferred indicatorof gastric cancer related tumor marker.(3) Stage III, IV gastric cancer, OPN concentration was significantlyhigher than the stageⅠ and Ⅱ,lymph node metastasis was higher than themetastasis (PN0); CA72-4concentration is higher than the group of tubularadenocarcinoma of signet ring cell carcinoma group, The difference wasstatistically significant (P<0.05), to distinguish between adenocarcinoma andsignet ring cell carcinoma significance of OPN in a group of tubularadenocarcinoma and signet ring cell carcinoma group was no significant.(4) Combined detection sensitivity was significantly higher than singletumor markers, the OPN+CEA+CA72-4+CA19-9sensitivity up to84.2%and a specificity of87.2%can be used as a gastric cancer combined detectionof the first choice.