| Part ?Analysis of Serum Associated Markers in Patients with Hp-positive Gastric CancerObjectives:The purpose of this study is to detect the expression of serum markers in Hp-positive gastric cancer patients,to explore the correlation between gastric cancer markers and gastric cancer diagnosis and different staging,to find the key markers affecting the prevalence of gastric cancer,objectively evaluate the value of each marker in the diagnosis and treatment of gastric cancer,and explore its mechanism from two aspects of clinical research and theory.Methods:The data of this study are all from MianYang Central Hospital.The data collected from February 2014 to December 2016 were all patients with complete primary medical records and basic personal information.After finishing the data finally get accurate and complete informatian and data,a total of 120 cases eligible.All cases were confirmed by clinical and pathological examination and radical gastrectomy in our hospital,and H.pylori(Hp)test was positive by Carbon breath test and fecal helicobacter pylori antigen detection.Using a completely random number table to select 120 healthy people in the same period into our hospital for examination as a control.The levels of Hb,CEA,CA19-9,CA72-4,PG?and PG? in Hp-positive patients with gastric cancer and healthy people were determined by chemiluminescence immunoassay and enzyme-linked immunosorbent assay(ELISA).Logistic regression analysis was used to analyze the influencing factors of Hp-positive gastric cancer survival time and the correlation between Hp-positive gastric cancer markers and clinical features of gastric cancer.Results: A total of 120 Hp-positive patients with gastric cancer who were admitted to our hospital from February 2014 to December 2016 were included in the study group.Among them,there were 83 male patients and 37 female patients aged 45-84 years.The average age is(59.75±8.75)years old.One hundred and twenty healthy subjects were randomly selected as the control group.There were 80 males and 40 females,ranging in age from 43 to 80 years with a mean age of 57.63±7.96 years.Compared with the control group,the Hb,CEA,CA19-9,CA72-4,PG ?and PG? in the study group were significantly different,the difference was statistically significant(P<0.05).Six serum markers had no significant difference in T staging of gastric cancer(P>0.05).The expression of Hb,CEA,CA19-9,CA72-4,PG?and PG? in different serum markers were compared with the N stage of gastric cancer,the difference was statistically significant(P<0.05).The expression of Hb,CEA,CA19-9,CA72-4,PG?and PG ?were compared with the degree of gastric cancer differentiation,the difference was statistically significant(P<0.05).There were no significant differences in the abnormal expression of 6 serum-related markers in gastric cancer patients with different tumor diameters and different tumor locations(P>0.05).The variables such as ag,smoking and alcohol consumption were the influencing factors of survival time of patients with Hp-positive gastric cancer,the difference was statistically significant(P<0.05).There was no significant correlation between serum markers and survival time of patients(P>0.05).Conclusion:This study found that there are a variety of serum-related markers in patients with gastric cancer,the expression of various markers is related to a variety of factors,the objective evaluation of the value of each marker in the diagnosis and treatment of gastric cancer has very important clinical significance.Part ? Diagnostic Value of Serum Markers for Gastric CancerObjectives:The purpose of this project is to evaluate the value of different markers in the diagnosis of gastric cancer by evaluating the changes of serum markers in patients with gastric precancerous lesions and gastric cancer.Methods:All the data in this study are from Mian Yang Central Hospital and collected from February 2014 to December 2016.120 patients with Hp-positive gastric cancer diagnosed in our hospital were selected as gastric cancer group,120 patients with Hp-negative chronic atrophic gastritis were selected as chronic atrophic gastritis group and 120 patients with Hp-negative chronic non-atrophic gastritis were selected as chronic non-atrophic gastritis group.The serum levels of Hb,CEA,CA19-9,CA72-4,PG?and PG?were analyzed in gastric cancer group,chronic atrophic gastritis group and chronic non-atrophic gastritis group.The changes of serum markers in three groups were compared.ROC curves were used to analyze the individual and combined diagnosis of gastric cancer.The diagnostic ability of each diagnosis index was compared.The diagnostic value of different serum markers in gastric cancer was comprehensively evaluated.Results:There was no significant difference in tumor markers between the groups of chronic atrophic gastritis and chronic non-atrophic gastritis(P>0.05),but there was a significant difference compared with gastric cancer group(both P<0.05).CEA,CA19-9 and CA72-4 three tumor markers in patients with different disease levels were significantly different(P<0.05).Gastric cancer group and chronic atrophic gastritis group serum PG?content compared with the chronic non-atrophic gastritis group were significantly different(all P<0.05),while there was significant difference in serum PG?content between gastric cancer group and chronic atrophic gastritis group(all P<0.05).The serum levels of Hb contents of gastric cancer group and chronic atrophic gastritis group were significantly different from those in chronic non-atrophic gastritis group(all P<0.05).There was no significant difference between gastric cancer group and chronic atrophic gastritis group(P>0.05).ROC curve detection of serum markers alone detect gastric cancer accuracy,sensitivity and specificity.The accuracy and sensitivity of PG and ?PG ?were as high as 73%,while the sensitivity of CEA,CA19-9 and CA72-4 was above 42%.The specificity of PG?and PG?was as high as above 76%,and the specificity of Hb,CEA,CA19-9 and CA72-4 were both above 50%.6 serum markers were detected by combined detection of tumor markers,pepsinogen and 6 serum markers.The combined detection of 6 serum markers had the highest sensitivity and specificity,Followed by the combination of pepsinogen and tumor markers.Compared with the single test,the accuracy,sensitivity and specificity of combined detection of 6 serum markers,combined detection of tumor markers and pepsinogen detection were increased,the difference was statistically significant(P<0.05).Conclusion:The changes of serum markers in patients with precancerous lesions of gastric cancer can reflect the possibility of carcinogenesis.All serum markers included in this study have certain diagnostic value for gastric cancer and the combined diagnosis of 6 serum markers is the most effective. |
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