| ObjectiveCollected 120 patients with esophageal cancer in the Affiliated Hospital of Taishan Medical College from 2010 to now,Used retrospective studyed the clinicopathological,serological indicators NSE,CEA,CA19-9,CA724 and clinicopathological data and analyzed the clinicopathological related factors,serological indicators and specificity and sensitivity of serological indicators used retrospective.Provided evidence for early diagnosis,malignant degree evaluation,therapeutic effect evaluation and prognosis of patients with esophageal cancer.MethodsCollected 120 patients as observation group which was diagnosed as early esophageal cancer in Affiliated Hospital of Taishan Medical College from December 2014 to December 2018.In addition,selected 120 healthy people as the control group in the same period of health examination center in our hospital.Developed the questionnaire of clinical and surgical pathological data of early esophageal cancer.Recorded the personal data,medical history and clinical symptoms,preoperative gastroscopy and other auxiliary examinations and postoperative pathological results of 120 patients with early esophageal cancer and 120 healthy people in the same period.Summarized and analyzed retrospectively the data and compared with the normal population.Determined the serum levels of NSE、CEA、CA19-9 and CA724 by ELI SA.Compared the levels of serum NSE,CEA,CA19-9 and CA724 between the two groups,the positive rates of serum NSE,CEA,CA19-9 and CA724 between the two groups.Compared the serum levels of NSE,CEA,CA19-9 and CA724 before and after operation in patients with early esophageal cancer.Compared the serum levels of NSE、CEA、CA19-9 and CA724 in patients with different ages and sexes.Analysed the correlation between serum levels of NSE、CEA、CA19-9、CA724 and clinicopathology in patients with esophageal cancer.Result1.The expression of serum NSE,CEA,CA19-9 and CA724 in early esophageal cancerThe mean serum CEA,CA19-9,NSE and CA724 levels in 120 patients with early esophageal cancer were(6.414±0.37)ng/ml,(22.23±1.19)U/l,(31.80±2.63)ug/L and(23.42±1.601))U/L respectively.The mean serum CEA level was(4.495±0.36)ng/ml,the average serum CA19-9 level was(18.22±1.19)U/l,the average serum NSE level was(15.97±6.01)ug/L and the average serum CA724 level was(16.49±1.27)U/L in the control group.The levels of NSE,CEA,CA19-9 and CA724 in patients with esophageal cancer were higher than those in healthy people(P<0.05).Serum CEA was positive in 29 of 120 patients with early esophageal cancer,the positive rate was 24.16%.Serum CA19-9 was positive in 42 cases(35.0%)and serum CA724 was positive in 36 cases(30.0%).Serum NSE was positive in 34 cases,the positive rate was 24.16%.The positive rate of serum CEA in control group was 9.16%.Serum CA19-9 was positive in 14 cases(11.67%)and serum CA724 was positive in 14 cases(11.67%).The positive rate of serum NSE was 9.17%.The positive rates of NSE,CEA,CA19-9 and CA724 markers in patients with esophageal cancer were higher than those in healthy people(P<0.05).2.Comparison of serum levels of NSE,CEA,CA19-9 and CA724 in patients with esophageal cancer before and after operationThe mean serum CEA,CA19-9,NSE and CA724 levels were(6.414±0.37)ng/ml,(22.23±1.19)U/l,(31.80±2.63)ug/L and(23.42±1.601)U/L respectively in 120 patients with early esophageal cancer before operation.The mean levels of serum CEA,CA19-9,NSE and CA724 were(5.92±0.34)ng/ml,(20.73±1.01)U/l,(27.98±1.43)ug/L and(20.12±1.40)U/L respectively.The levels of NSE,CEA,CA19-9 and CA724 after operation showed a downward trend compared with those before operation(P<0.05).3.Analysis of the correlation between serum NSE,CEA,CA19-9,CA724 and demog-raphic data3.1 Comparison of serum levels of NSE,CEA,CA19-9 and CA724 in patients with esophageal cancer of different sexesThere were 120 patients with early esophageal cancer,85 males and 35 females.The average levels of serum CEA,CA19-9,NSE and CA724 were(6.04±0.36)ng/ml,(20.73±1.09)U/l,(22.08±1.63)ug/L and(18.41±1.51)U/L respectively.The average levels of CEA,serum CA19-9,NSE and serum CA724 in women were(6.02±0.38)ng/ml,(21.13±1.21)U/l,(21.99±2.43)ug/L and(19.02±1.61)U/L respectively.The expression levels of NSE,CEA,CA199 and CA724 in different sex esophageal cancer patients were not different(P>0.05).3.2 Comparison of serum levels of NSE,CEA,CA19-9 and CA724 in patients with esophageal cancer of different agesThere were 120 patients with early esophageal cancer,13 patients with less than 50 age,52 patients with 50～60 age and 57 patients with greater than 60 age.The average level of serum CEA,CA19-9,NSE and CA724 were(6.94±0.41)ng/ml,(21.84±1.09)U/l,(25.01±1.59)ug/L and(24.91±1.32)U/L respectively in the patients with less than 50 age.The average levels of CEA,serum CA19-9,NSE and serum CA724 in the patients with50～60 age were(7.02±0.48)ng/ml,(21.73±1.10)U/l,(24.98±1.45)ug/L and(25.02±1.36)U/L respectively.The average level of serum CEA,CA19-9,NSE and CA724 in the patients with greater than 60 age were(7.08±0.51)ng/ml,(22.03±1.13)U/l,(25.08±1.43)ug/L and(29.98±1.34)U/L respectively.The expression levels of NSE,CEA,CA19-9 and CA724 in esophageal cancer patients of different ages had no difference(P>0.05).4.Analysis of the correlation between serum NSE,CEA,CA19-9,CA724 and Clinico-pathology4.1 Comparison of serum NSE,CEA,CA19-9 and CA724 levels in different TNM stagesAmong 120 patients with early esophageal cancer,30were in TNM stage 0,35 were in TNM stage I and,55 were in stage II.The average level of serum CEA,CA19-9,NSE and CA724 in patients in TNM stage 0 were(4.84±0.63)ng/ml,(19.11±0.98)U/l,(20.18±1.43)ug/L and(15.41±0.99)U/L respectively.The average level of serum CEA was(5.04±0.36)ng/ml,the average level of serum CA19-9 was(20.13±1.09)U/l,the average level of serum NSE was(22.08±1.63)ug/L,and the average level of serum CA724 was(18.41±1.50)U/L.The average level of serum CEA,CA19-9,NSE and CA724 in TNM stage Ⅱ were(7.02±0.38)ng/ml,23.73±1.21)U/l,34.98±2.43)ug/L and 25.02 ±1.60)U/L respectively.The levels of NSE,CEA,CA19-9 and CA724 were different among the three groups(P<0.05).Serum levels of NSE,CEA,CA19-9 and CA724 in patients with TMN II were higher than those in patients with I.Serum levels of NSE,CEA,CA19-9 and CA724 in patients with TMN I were higher than those in patients with stage 0.4.2 Comparison of the serum levels of NSE,CEA,CA19-9 and CA724 in esophageal cancer patients with different diametersAmong 120 patients with early esophageal cancer,35 patients with a diameter of less than 2 cm,45 patients with a diameter of 2 cm to 3 cm,and 40 patients with a diameter of more than 3 cm.The mean serum CEA,CA19-9,NSE and CA724 levels in patients with tumor diameter less than 2 cm were(4.04±0.26)ng/ml,(19.01±0.98)U/l,(18.07±0.93)ug/L and(15.01±0.80)U/L respectively.The mean serum CEA,CA19-9,NSE and CA724 levels were(5.02±0.28)ng/ml,21.73±1.14)U/l,30.97±2.43)ug/L and(20.09 ±1.02)U/L,respectively.The mean serum CEA,CA19-9,NSE and CA724 levels were(7.92±0.48)ng/ml,(24.63±1.24)U/l,(35.99±2.53)ug/L,(25.92 ±1.61)U/L,respectively.The levels of NSE,CEA,CA19-9 and CA724 were different among the three groups(P<0.05).The levels of four markers in patients increased with esophageal cancer with larger tumor diameter.4.3 Comparison of serum levels of NSE,CEA,CA19-9 and CA724 in esophageal cancer patients with different invasive degrees120 cases of early esophageal cancer,30 cases of in situ cancer,46 cases of intramucosal cancer,44 cases of submucosal cancer.The average level of serum CEA,CA19-9,NSE and CA724 in patients with carcinoma in situ were(4.84±0.63)ng/ml,(19.11±0.98)U/l,(20.18±1.43)ug/L and(15.41±0.99)U/L respectively.The mean serum CEA,CA19-9,NSE and CA724 levels in patients with intramucosal cancer were(7.02±0.68)ng/ml,(21.98 ±1.12)U/l,(28.96±2.73)ug/L and(25.02±1.60)U/L respectively.The mean levels of serum CEA,CA199,NSE and CA724 in patients with submucosal cancer were(9.12±0.78)ng/ml,(25.93±1.29)U/l,(35.98±2.93)ug/l and(29.12+1.63)U/L respectively.The levels of NSE,CEA,CA19-9 and CA724 were different among the three groups(P<0.05).The levels of four markers increased with the increase of infiltration degree.5.Diagnostic value of NSE,CEA,CA19-9 and CA724 markers in early esophageal cancer5.1 The value of serum CEA in the Diagnosis of Early Esophageal Carcinoma The ROC curve of CEA in the diagnosis of early esophageal cancer was analyzed to evaluate the diagnostic value of serum CEA in early esophageal cancer.ROC curve analysis showed that the area under curve(AUC)was 0.699,95%CI was 0.630～0.769,p=0.035;CEA had certain diagnostic value for early esophageal cancer,the optimal threshold was 11.45 ng/ml,the corresponding sensitivity was 50.7%,specificity was 62.5%.5.2 The value of serum CA19-9 in the Diagnosis of Early Esophageal Carcinoma The diagnostic value of serum CA19-9 in early esophageal cancer was evaluated by ROC curve analysis.ROC curve analysis showed that the area under curve(AUC)was 0.601,95%CI was 0.529～0.673,p=0.037;CA19-9 had certain diagnostic value for early esophageal cancer,the optimal threshold was 33.69 ug/L,the corresponding sensitivity was 40.7%,and the specificity was 52.5%.5.3 The value of serum NSE in the Diagnosis of Early Esophageal CarcinomaThe ROC curve of NSE in the diagnosis of early esophageal cancer was analyzed to evaluate the diagnostic value of serum NSE in early esophageal cancer.ROC curve analysis showed that the area under curve(AUC)was 0.543,95%CI was 0.469-0.616,p=0.254;NSE had a small diagnostic value for early esophageal cancer,the optimal threshold was 23.69 IU/ML,the corresponding sensitivity was 30.71%,and the specificity was 32.5%.5.4 The value of serum CA724 in the Diagnosis of Early Esophageal Carcinoma The diagnostic value of serum CA724 in early esophageal cancer was evaluated by ROC curve analysis.ROC curve analysis showed that the area under curve(AUC)was 0.585,95%CI was 0.511-0.658,p=0.023;CA724 had certain diagnostic value for early esophageal cancer,the optimal threshold was 29.69 U/L,the corresponding sensitivity was 40.71%,specificity was 52.5%.5.5 The value of four tumor markers in the Diagnosis of Early Esophageal CarcinomaThe sensitivity and specificity of the combined detection of any two indicators are higher than those of single indicators.The sensitivity and specificity of the combined detection of the three indicators were higher than those of the two indicators.The sensitivity and specificity of the combined detection of the four indicators were the highest,reaching 71.2%and 81.9%.Conclusion:The serum levels of NSE,CEA,CA19-9 and CA724 in patients with esophageal cancer were significantly higher than those in the normal group.The expression of four tumor markers decreased after operation.The serum levels of NSE,CEA,CA19-9 and CA724 in patients with TMN Ⅱ were higher than those in patients with I.The larger the diameter of tumors,the deeper the infiltration degree,and the higher the serum levels of NSE,CEA,CA19-9 and CA724.However,there were no differences in serum levels of NSE,CEA,CA19-9 and CA724 among patients of different ages and genders(P>0.05).CA19-9 and CA724 have certain diagnostic value for early esophageal cancer,which are lower than the combined detection index.The sensitivity and specificity of four tumor markers for early diagnosis of esophageal cancer were 71.2%and 81.9%respectively.The sensitivity and specificity of the combined detection of any two indicators are higher than those of single indicators.The sensitivity and specificity of the combined detection of the three indicators were higher than those of the two indicators. |
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