胃癌患者血清同型半胱氨酸、神经元特异性烯醇化酶和糖类抗原72-4水平及与临床特征和预后的关系

Levels of serum homocysteine,neuron specific enolase,and carbohydrate antigen 72-4 in patients with gastric cancer and their relationship with clinical characteristics and prognosis

目的 探究胃癌患者血清同型半胱氨酸(Hcy)、神经元特异性烯醇化酶(NSE)和糖类抗原72-4(CA72-4)水平及与临床特征和预后的关系。方法 选取117例胃癌患者及64例胃部良性疾病患者,分别作为胃癌组及良性组,比较两组患者的血清Hcy、NSE、CA72-4水平。分析胃癌患者血清Hcy、NSE、CA72-4水平与临床特征的关系,探讨血清Hcy、NSE、CA72-4单独及联合检测对胃癌的诊断价值及对预后的预测价值。结果 胃癌组患者血清Hcy、NSE和CA72-4水平均明显高于良性组,差异均有统计学意义(P﹤0.01)。血清Hcy、NSE和CA72-4联合检测诊断胃癌的曲线下面积(AUC)大于各指标单独检测。不同分化程度、临床分期、淋巴结转移情况、浸润深度胃癌患者的血清Hcy、NSE、CA72-4水平比较,差异均有统计学意义(P﹤0.05)。死亡组患者Hcy、NSE和CA72-4水平均明显高于生存组,差异均有统计学意义(P﹤0.01)。血清Hcy、NSE和CA72-4联合检测预测胃癌患者预后的AUC大于各指标单独检测。Logistic回归分析结果显示,Hcy≥16.61μmol/L、NSE≥60.24 ng/ml、CA72-4≥32.08 U/ml均是胃癌患者预后的危险因素(P﹤0.05)。Hcy≥16.61μmol/L、NSE≥60.24 ng/ml、CA72-4≥32.08 U/ml胃癌患者的3年生存率分别低于Hcy﹤16.61μmol/L、NSE﹤60.24 ng/ml、CA72-4﹤32.08 U/ml的患者,差异均有统计学意义(P﹤0.05)。结论 胃癌患者血清Hcy、NSE和CA72-4水平与分化程度、临床分期等临床特征有关,且各指标联合检测对胃癌具有诊断价值,对患者预后具有预测价值。

Objective To investigate the levels of serum homocysteine(Hcy),neuron specific enolase(NSE),and carbohydrate antigen 72-4(CA72-4) in patients with gastric cancer and their relationship with clinical characteristics and prognosis.Method A total of 117 patients with gastric cancer and 64 patients with benign gastric diseases were selected as gastric cancer group and benign group respectively.The serum Hcy,NSE,and CA72-4 levels of the two groups were compared.The relationship between serum Hcy,NSE,CA72-4 levels and clinical characteristics of gastric cancer patients were analyzed.The diagnostic value and prognostic predictive value of serum Hcy,NSE,and CA72-4 alone and combined detection for gastric cancer were discussed.Result The serum Hcy,NSE,and CA72-4 levels in the gastric cancer group were significantly higher than those in the benign group,and the differences were statistically significant(P<0.01).The area under the curve(AUC) of the combined detection of serum Hcy,NSE,and CA72-4 in diagnosing gastric cancer was larger than the individual detection of each indicator.There were statistically significant differences in serum Hcy,NSE,and CA72-4 levels among gastric cancer patients with different degrees of differentiation,clinical stage,lymph node metastasis,and depth of invasion(P<0.05).The levels of Hcy,NSE,and CA72-4 in the death group were significantly higher than those in the survival group,and the differences were statistically significant(P<0.01).The AUC of the combined detection of serum Hcy,NSE,and CA72-4 in predicting prognosis of gastric cancer patients was larger than the individual detection of each indicator.Logistic regression analysis results showed that Hcy≥16.61 μmol/L,NSE≥60.24 ng/ml,and CA72-4≥32.08 U/ml were risk factors for the prognosis of gastric cancer patients(P<0.05).The 3-year survival rates of gastric cancer patients with Hcy≥16.61 μmol/L,NSE≥60.24 ng/ml,and CA72-4≥32.08 U/ml were respectively lower than those with Hcy<16.61 μmol/L,NSE<60.24 ng/ml,and CA72-4<32.08 U/ml patients,the differences were statistically significant(P<0.05).Conclusion Serum Hcy,NSE and CA72-4 levels in gastric cancer patients are related to clinical characteristics including differentiation degree,clinical stage,and so on.The combined detection of the above indicators has diagnostic value for gastric cancer and predictive value for patient prognosis.