| BackgroundGastric cancer is one of the most common malignant tumors in China, and the morbidity and mortalit rate are still high in recent years. For gastric cancer, chemotherapy is an effective method for patients with advanced disease. Part of patients with early gastric cancer could accept operation and adjuvant chemotherapy. And part of patients diagnosed with advanced gastric cancer have to be treated with palliative chemotherapy. For many patients, progress of the disease is unavoidable, therefore, it is crucial to predict the responsiveness of chemotherapy when treating patients with gastric cancer. Now, the efficacy and safety of pemetrexed based chemotherapy in treatingPatients with advanced gastric cancer who failed to respond to first and(or) second line chemotherapy is well accepted. Clinical detection of tumor mark e.g., AFP(alpha fetoprotein), CEA(carcinoembryonic antigen), 125(glycogen 125),CA199(glycogen 199),CA153(glycogen 153), PSA(prostate specific antigen),NSE(neuron specific enolase) and c YFRA21-1(cytokeratin fragment antiogen 21-1) has been widely applied. But at present, other tumor markers with higher sensitivity and specificity are required for patients with gastric cancer. A variety of abnormal sugar chain glycoprotein produced during the multistep development of human tumors. These abnormal sugar chain combined with calcium- histone proteins, were known as TAP(Tumor abnormal protein). TAP is a combined detection of dozens of abnormal sugar chains in tumor markers, eg., AFP, CEA, PSA, CA series, O- sugar chain protein, transferrin, alkaline phosphatase, γ-glutamyltransferase, human chorionic gonadotropin(HCG), T antigen, α1-antitrypsin and prostatic acid phosphatase. The variation of TAP is more obvious than the variation of single tumor marker, and could be more sensitive in evaluating the efficacy of chemotherapy for patients with gastric cancer. The aim of this study was to compare the predictive value of TAP with several common tumor markers, eg., CEA,, CA125 and CA199 in gastric cancer. And explore whether TAP could effectively predict the responsiveness of chemotherapy.Materials and MethodsFrom September 2014 to February 2015, 82 inpatients with gastric cancer accepted chemotherapy in Jiangsu Cancer Hospital & Research Institute. They were divided into two groups, group A with early gastric cancer treated with adjuvant chemotherapy based on platinum with fluorouracil, and group B with advanced gastric cancer treated with palliative chemotherapy based on pemetrexed. Before and after two cycles of chemotherapy, all patients accepted CT(computed tomography) scan and blood detection e.g., TAP, CEA, CA125, and CA199.Associations between the variation of TAP and patients’ age, gender, organ metastasis and grade of malignancy were investigated with logistic analysis. Before and after chemotherapy, the relation between the responsiveness of adjuvant therapy and tumor markers in group A was analyzed with the regression analysis. And the relation between the responsiveness of palliative therapy and variation of TAP was analyzed with the correlation analysis. Associations between the variation of TAP and the variation of CEA, CA125 and CA199 were analyzed with the regression analysis.Results1 Variation of TAP,CEA,CA125 and CA199 were compared with the baseline characters e.g., age, gender, organ metastasis and grade of malignancy, and P>0.05. It suggested the baseline characters would not influence the variation of TAP, CEA, CA125, CA199 in patients with gastric.2 Before and after chemotherapy, the relation between TAP and the responsiveness of palliative chemotherapy in patients with gastric cancer was analyzed and P<0.05, r=0.80(Table 3). The responsiveness of palliative chemotherapy is considered highly correlated with the variation of TAP, the level of TAP decreased when CT scan showed disease controlled and increased in disease progression. The relation between CEA and the responsiveness of palliative chemotherapy was analyzed and P<0.05, r=0.62; the correlation between CA125 and the responsiveness of palliative chemotherapy was analyzed and P<0.05, r=0.73; the correlation between CA199 and the responsiveness of palliative chemotherapy was analyzed and P<0.05, r=0.63. The correlation between responsiveness of palliative chemotherapy and TAP is stronger than the correlation between several conventional serum tumor markers(CEA, CA125 and CA199). The variation of TAP is closely related with the responsiveness of palliative chemotherapy. TAP is sensitive in monitoring responsiveness of palliative chemotherapy.3 Before and after chemotherapy, the relationship between the variation of TAP and tumor markers in group A was analyzed with the regression analysis. The variation of TAP was compared with CEA, P<0.05 and 0 is not contained in the 95% confidence intervals. The correlation of CA125 is 0.49, suggested a positive impact on TAP. The value of TAP increased with the value of CA125; conversely, the value of TAP decreased with the value of CA125. The variation of TAP was compared with CEA and CA199, P>0.05 and 0 is not contained in the 95% confidence intervals. It suggested the trend of the value of TAP is not associated with the trend of CEA and CA199. The variation of TAP was positively correlated with the trend of CA125, but not correlated with CEA and CA199 in adjuvant chemotherapy. The variation of TAP in group B was compared with CEA, CA125 and CA199, P>0.05 and 0 is contained in the 95% confidence intervals. It suggested the trend of the value of TAP is not associated with the trend of CEA, CA125 and CA199 in patients with advanced gastric cancer in this study.ConclusionTAP is sensitive in monitoring the responsiveness to palliative chemotherapy in patients with advanced gastric cancer. The variation of TAP would provide important guidance for the individualized treatment of patients with gastric cancer. |
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