肿瘤标志物及免疫组织化学蛋白表达水平与胃癌淋巴结转移相关性及预后研究

Correlation of tumor markers and immunohistochemical protein expression levels with lymph node metastasis and prognosis of gastric cancer

目的 探讨肿瘤标志物及免疫组织化学蛋白与胃癌淋巴结转移(LNM)的相关性及预后研究。方法 选择2015年1月-2018年8月武警湖北省总队医院行手术治疗的胃癌患者368例(LNM组60例和非LNM组308例),比较2组患者术前肿瘤标志物和免疫组织化学蛋白表达差异。评估肿瘤标志物与临床指标的相关性及其对早期胃癌LNM的预测价值,分析胃癌预后生存时间的影响因素。结果 LNM组术前CA125、CEA和CA199水平明显高于非LNM组(P <0.05);CEA与年龄、性别存在相关性(P <0.05),CA199与年龄存在相关性(P <0.05);CA125、CA199、CEA阳性对早期胃癌LNM有预测价值(P <0.05),其中CEA的预测价值最高;CA125、CA199、CEA升高患者预后较差,且CA125、CA199和CEA是胃癌患者预后不良的独立危险因素(P <0.05)。结论 CA125、CEA和CA199水平明显升高对胃癌LNM具有预测价值,参与胃癌预后不良。

Objective To investigate the correlation and prognosis of tumor markers and immunohistochemical proteins with lymph node metastasis(LNM) of gastric cancer. Methods 368 patients with gastric cancer in Hubei Provincial General Hospital of Armed Police Force from January 2015 to August 2018 were selected,with 60 in the LNM group and 308 in the non-LNM group. The expressions tumor markers and immunohistochemical protein were compared between the two groups, to evaluate the correlation between tumor markers and various clinical indexes, the receiver operating characteristic curve(ROC) was used to determine the predictive value of tumor markers for LNM of early gastric cancer, and the Cox proportional risk regression model was used to analyze the influencing factors of prognostic survival time of gastric cancer. Results The preoperative levels of CA125, CEA and CA199 in the LNM group were significantly higher than those in the non-LNM group(P < 0.05). CEA was correlated with age and gender(P < 0.05), CA199 was correlated with age(P < 0.05);positive CA125, CA199 and CEA had a predictive value for LNM in early gastric cancer(P <0.05), CEA had the highest predictive value, respectively;patients with elevated CA125, CA199 and CEA had a poor prognosis(P < 0.05), CA125, CA199 and CEA were independent risk factors for poor prognosis in gastric cancer patients(P < 0.05). Conclusion Significant increase of CA125, CEA and CA199 levels has predictive value for LNM of gastric cancer, which is involved in the poor prognosis of gastric cancer.