| Objective:Gastric cancer is one of the main causes of direct death in cancer,and incidence rate is high in South America,Eastern Europe and East Asia.In China,the incidence rate of gastric cancer ranks second in all malignant tumors,second only to lung cancer.The early diagnosis rate of gastric cancer is only 20%,most of which are advanced,and the 5-year survival rate is less than 50%.The symptoms of early gastric cancer patients are not typical.If not found in time,with the continuous progress of the disease,severe anemia,emaciation,pain and other symptoms may occur.Direct infiltration,peritoneal metastasis,lymph node metastasis and hematogenous metastasis are the main ways of gastric cancer metastasis.If the disease can not be diagnosed and treated in time,it can be transferred to other organs and tissues,which has a bad effect on the prognosis.Therefore,it is very important to diagnose and treat gastric cancer as soon as possible.The exploration of biomarkers involved in the progression of gastric cancer can promote its early diagnosis and improve its prognosis.In this paper,five coagulation markers,AFP,CEA,CA72-4,CA199,CYFRA21-1 and NSE were jointly detected to explore the value and significance in the diagnosis of gastric cancer.Methods:From August 2017 to April 2019,126 gastric cancer patients(group A)were randomly selected from the Third Affiliated Hospital of Anhui Medical University,including 86 males and 40 females,aged 36-78 years,16 in stage I,18 in stage II,55 in stage III and 37 in stage IV.There were 124 cases in the benign gastric disease group(group B),70 males and 54 females,aged 22-86 years,including 48 cases of chronic gastritis,23 cases of gastric ulcer,37 cases of gastric polyps,16 cases of gastric stromal tumor,without malignant history.There were 134 cases in the physical examination group(Group C),including 83 males and 51 females,aged21-83 years.Inclusion criteria:(1)all patients in group A and B were confirmed by gastroscopy and CT;(2)none of them had thrombotic disease before the test;(3)none of them had vein replacement;(4)none of them had malignant disease.Exclusion criteria: three groups of subjects:(1)patients with heart and lung dysfunction;(2)patients with tumors in other organs;(3)pregnant or lactating women.Three groups of fasting venous blood were collected in the morning.Five coagulation markers,AFP,CEA,CA72-4,CA199,CYFRA21-1 and NSE were detected by automatic coagulation analyzer and automatic chemiluminescence immunoassay respectively to determine the diagnostic value of the combined detection.Results:The levels of D-D,CEA,CA724 and CYFRA21-1 in gastric cancer group were significantly higher than those in benign gastric disease group and healthy physical examination group(P < 0.05).The serum levels of D-D,CEA,CA72-4 and CYFRA21-1 in patients with stage I and stage II gastric cancer were significantly lower than those in patients with stage III and stage IV gastric cancer(P < 0.05),indicating that with the prolongation of tumor stage,the serum levels of the above indicators in patients with gastric cancer were significantly increased,and the combined detection could improve the sensitivity and specificity of diagnosis,including four indicators of D-D + CEA + CA724 + CYFRA21-1 The accuracy of combined detection is the highest.Conclusion:The combined detection of D-dimer and tumor markers CEA,CA72-4and CYFRA21-1 in coagulation five items can further improve the early detection rate of gastric cancer,and then improve the diagnosis rate,which has high clinical application value. |
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