The Value Of Gastrin-17,CEA,CA199 And CA125 Combined Detection On Gastric Cancer

Objective: To investigate the application value of combined detection of serum gastrin 17(G-17),carcinoembryonic antigen(CEA),carbohydrate antigen 199(CA199)and carbohydrate antigen 125(CA125)in gastric cancer screening.Method: 230 cases of gastric cancer patients admitted to the department of gastrointestinal gland surgery of the First Affiliated Hospital of Guangxi Medical University from August 2018 to November 2019 were respectively collected as the observation group(the specific clinical date of this group included the patient’s name,gender,age,height,weight,G-17,CEA,CA199,CA125,tumor site,degree of differentiation and TNM staging,etc.),99 healthy individuals were collected as the control group during the same period(the data included the patient’s name,gender,age,height,weight and the serum levels of G-17,CEA,CA199 and CA125,etc).All cases in both the observation group and the control group were tested for CEA,CA19-9 and CA125 by using electrical chemiluminescent immunoassay(ECLIA)and the serum levels of G-17 were detected by Enzyme-linked immunosorbent(ELISA).All data was processed by SPSS22.0,measurement data that conform to a normal distribution are represented by and the quantitative data were expressed by(?)±S and Measurement data that do not conform to the normal distribution are represented by the median(P25-P75).The independent sample t test,chi-square test,nonparametric statistical Mann Whitney rank sum test and Kruskal Wallis test were used to analyze the differences among data groups,and P<0.05 was considered statistically significant.The diagnostic parameters of single detection and combined detection of the above four indicators between the two groups of cases were recorded and analyzed,including sensitivity(Sen),specificity(Spe),accuracy(Acc),positive predictive value(PPV),negative predictive value(NPV),positive likelihood ratio(Pos LR)and negative likelihood ratio(Neg LR).Receiver operating curve(ROC curve)was plotted for the diagnosis of gastric cancer by single indicator alone and in combination with each indicator.By analyzing the area under the curve(AUC),the diagnostic value of G17,CEA,CA199 and CA125 single and combined detection were explored.In addition,the relationship between serum levels of G-17,CEA,CA199,CA125 and tumor size,site,differentiation and clinical stage of gastric cancer was further analyzed.Result:1.The serum levels of G-17,CEA,CA199 and CA125 in the observation group were 4.55(2.08-13.96)pmol/L、2.22(1.36-4.77)ng/ml 、10.00(3.30-24.21)Uarb/ml 、 11.55(8.20-17.28)Uarb/ml while those in the control group were1.95(1.08-3.85)pmol/L 、 1.76(1.13-2.36)ng/ml 、 4.51(2.33-9.39)Uarb/ml 、 9.40(6.90-13.50)Uarb/ml.Compared with the control group,serum G-17,CEA,CA199 and CA125 levels in observation group are increased(P<0.05).The positive rate of serum G-17,CEA,CA199 and CA125 in detection of gastric cancer was respectively 22.61%,22.61%,20.00% and 8.26%.In the control group,they were 5.05%,2.02%,1.01% and 2.02%,respectively.The positive rate of serum G-17、CEA and CA199 levels in patients with gastric cancer were significantly higher than those in the control group.2.The sensitivity of gastric cancer among G-17,CEA,CA199 and CA125 was 22.61%,22.61%,20.00% and 8.26% respectively.The sensitivity of four combined detection for the diagnosis of gastric cancer was 60.87%,which was significantly higher than that of the single index.The specificity of G-17,CEA,CA199 and CA125 in the diagnosis of gastric cancer were 94.95%,97.98%,98.99%,97.98% respectively and the specificity of the combined diagnosis of gastric cancer by the four indexes was 89.90%.3.For the ROC curve,the AUC of G-17,CEA,CA199 and CA125 in the diagnosis of gastric cancer was 0.717,0.635,0.646 and 0.607,respectively.The efficacy of G-17 in the diagnosis of gastric cancer was significantly higher than that of tumor markers such as CEA,CA199 and CA125.The combination of the three indexes of G-17+CEA+CA199 and the combination of the four indexes was the most effective in the diagnosis of gastric cancer,and the area under the ROC curve was 0.794.However,the sensitivity of the combination of four indicators in the diagnosis of gastric cancer was 92.17%,significantly higher than that of the combination of G-17 +CEA+CA199,which was85.22%.4.According to ROC curve analysis,the clinical diagnostic critical points of G-17,CEA,CA199 and CA125 in patients with gastric cancer were3.855pmol/L,3.385ng/ml,9.445Uarb/ml and 9.750Uarb/ml.When those clinical diagnostic critical points were used to detect gastric cancer,the sensitivity can be increased to 59.13%,34.78%,52.61% and 66.09%.The area under the ROC curve of G-17 diagnosis of gastric cancer was the highest,and the AUC was 0.717.Its sensitivity and accuracy for the diagnosis of gastric cancer were higher than those of CEA,CA199,CA125 and other traditional tumor markers.The sensitivity of the combined four indexes in the diagnosis of gastric cancer was the highest(92.17%).5.In the analysis of the relationship between the levels of serum G-17,CEA,CA199,CA125 and the clinicopathological characteristics of gastric cancer.There was no significant correlation between G-17 and the gender,age,tumor site,tumor size,invasion degree,differentiation degree,lymph node metastasis,distant metastasis,and clinical stage of gastric cancer patients(P>0.05).CEA was associated with tumor size,invasion depth,distant metastasis,differentiation,clinical stage and presence of distant metastasis in patients with gastric cancer(P<0.05).CA199 was correlated with tumor size,infiltration depth,distant metastasis,clinical stage and other factors in patients with gastric cancer,and the difference was statistically significant(P<0.05).The expression of serum CA125 was significantly correlated with the presence or absence of distant metastasis in gastric cancer patients.The expression level of CA125 in the serum of gastric cancer patients with distant metastasis was significantly higher than that of those without distant metastasis(P<0.05).Conclusions:1.Serum levels of G-17,CEA,CA199 and CA125 in patients with gastric cancer were higher than those in healthy patients.G-17,CEA,CA199 and CA125 can be used as indicators for screening gastric cancer.2.The sensitivity of serum G-17,CEA,CA199 and CA125 was low in the diagnosis of gastric cancer,and the combination of the four indicators was more valuable than single detection in the diagnosis of gastric cancer.3.Tumor markers such as CEA,CA199 and CA125 have certain implications for the clinicopathological characteristics of gastric cancer of gastric cancer.The level of G-17 was not closely related to tumor markers such as CEA,CA199 and CA125 have certain implications for the clinicopathological characteristics of gastric cancer.