免疫组化指标及肿瘤标志物与胃癌临床病理特征的相关性

Correlation of immunohistochemical indexes and tumor markers with clinicopathological characteristics of gastric cancer

目的探讨免疫组化指标及肿瘤标志物与胃癌临床病理特征的相关性。方法选取我院确诊的胃癌患者60例作为研究组,选取同期体检健康者60例作为对照组,观察两组血清肿瘤标志物表达水平,探讨肿瘤标志物表达水平与胃癌临床病理特征的关系,观察研究组人体表皮因子-2(Her-2)的表达情况,比较Her-2阳性表达与Her-2阴性表达的临床病理特征,绘制受试者工作特征曲线(ROC),分析血清CEA、CA72-4、CA125、CA19-9水平及Her-2阳性表达对胃癌的诊断价值。结果研究组肿瘤标志物癌胚抗原(CEA)、糖类抗原72-4(CA72-4)、糖类抗原125(CA125)、糖类抗原19-9(CA19-9)指标水平均高于对照组(P<0.05);60例胃癌患者中,Her-2阳性表达8例,Her-2阳性表达率为13.33%;Her-2阳性表达患者的淋巴结转移、肿瘤中高分化例数高于Her-2阴性表达患者(P<0.05);研究组中,不同临床分期、不同淋巴结转移、肿瘤分化程度患者CEA、CA125、CA72-4、CA19-9阳性表达率比较,P<0.05,而与性别、年龄无关(P>0.05);ROC分析结果显示,血清CEA、CA72-4、CA125、CA19-9水平及Her-2阳性表达对胃癌诊断的AUC值分别为0.806、0.762、0.767、0.777、0.930(P<0.05),且Her-2阳性表达诊断胃癌的灵敏度、特异度最高,分别为86.67%、83.33%。结论血清肿瘤标志物CEA、CA72-4、CA125、CA19-9表达水平与肿瘤的分化程度、淋巴结转移、临床分期相关,而Her-2表达水平与淋巴结转移、肿瘤分化程度相关,血清CEA、CA72-4、CA125、CA19-9水平及Her-2阳性表达在胃癌诊断中具有一定价值。

Objective To explore the correlation of immunohistochemical indexes and tumor markers with clinicopathological characteristics of gastric cancer.Methods Sixty patients with gastric cancer in our hospital were selected as the research group,and 60 healthy people during the same period were selected as the control group.The expression levels of serum tumor markers in the two groups were observed to explore its correlation with clinicopathological characteristics of gastric cancer.The expression of human epidermal factor-2(Her-2)in the research group was observed,the clinicopathological characteristics of Her-2 positive expression and Her-2 negative expression were compared.The examinee’s operating characteristic curve(ROC)was drawn.The diagnostic value of serum CEA,CA72-4,CA125,CA19-9 levels and Her-2 positive expression for gastric cancer was analyzed.Results The tumor markers carcinoembryonic antigen(CEA),carbohydrate antigen 72-4(CA72-4),carbohydrate antigen 125(CA125),carbohydrate antigen 19-9(CA19-9)index levels in the research group were higher than those in the control group(P<0.05).Among 60 patients with gastric cancer,8 cases were Her-2 positive expression(13.33%),the cases of lymph node metastasis,tumor middle-to-highly differentiated in Her-2 positive expression patients were more than those in the negative expression(P<0.05).In the research group,there are statistical difference in the positive rates of CEA,CA125,CA72-4 and CA19-9 expression among patients with different clinical stages,different lymph node metastasis,and different degrees of tumor differentiation(P<0.05).ROC analysis results showed that the AUC value of serum CEA,CA72-4,CA125,CA19-9 levels and Her-2 positive expression in the diagnosis of gastric cancer were 0.806,0.762,0.767,0.777 and 0.930(P<0.05).Her-2 positive expression had the highest sensitivity and specificity in the diagnosis of gastric cancer,which were 86.67%and 83.33%respectively.Conclusion The expression levels of serum tumor markers CEA,CA72-4,CA125,and CA19-9 are related to tumor differentiation,lymph node metastasis and clinical stage,while Her-2expression levels are related to lymph node metastasis and tumor differentiation.The levels of CA72-4,CA125,CA19-9 and the positive expression of Her-2 have value in the diagnosis of gastric cancer.