血清CA125、CA199、CEA、AFP表达水平与胃癌患者预后的相关性研究

Correlation of serum CA125,CA199,CEA and AFP expression with prognosis in gastric cancer patients

目的研究血清癌胚抗原(CEA)、血清甲胎蛋白(AFP)、糖类抗原199(CA199)、糖类抗原125(CA125)表达水平与胃癌患者预后的相关性。方法选取2019年1月至2021年1月南阳市第二人民医院收治的胃癌患者136例为研究组,另随机抽取68例门诊健康体检者为对照组。检测胃癌患者与体检人群的血清CA125、CA199、CEA和AFP水平。根据患者随访期间的具体情况,分为预后良好组87例与预后不良组49例。比较血清AFP、CEA、CA125、CA199不同水平患者的复发率、转移率及病死率,采用受试者工作特征(ROC)曲线分析血清AFP、CEA、CA125、CA199对预后不良的预测价值。结果研究组血清CA125、CA199、CEA和AFP水平高于对照组,差异有统计学意义(P<0.05)。预后良好组血清CA125、CA199、CEA和AFP水平均低于预后不良组,差异有统计学意义(P<0.05)。高水平组复发率、转移率、病死率均高于低水平组,差异有统计学意义(P<0.05)。血清AFP、CEA、CA125、CA199预测胃癌患者预后不良的曲线下面积(AUC)分别为0.730、0.759、0.689、0.791,灵敏度和特异度分别为67.3%、73.5%、65.3%、73.5%和86.2%、78.2%、75.9%、86.2%,联合检测的AUC、灵敏度和特异度分别为0.906、77.6%、92.0%,联合检测的预测价值均高于各项的单独检测。结论血清CA125、CA199、CEA和AFP在胃癌患者中处于较高水平,监测这些指标对胃癌患者的预后不良具有一定预测价值。

Objective To study the correlation of levels of serum carcinoembryonic antigen(CEA),alpha-fetoprotein(AFP),carbohydrate antigen 199(CA199),carbohydrate antigen 125(CA125)expression with prognosis of gastric cancer patients.Methods A total of 136 gastric cancer patients admitted to the Second People’s Hospital of Nanyang City from January 2019 to January 2021 were selected as the study group,another 68 outpatient health checkups were randomly selected as the control group.The serum levels of CA125,CA199,CEA,and AFP in gastric cancer patients and physical examination population were detected.According to the specific situation of the patient during follow-up,they were divided into a good prognosis group of 87 cases and a poor prognosis group of 49 cases.The recurrence rate,metastasis rate,and mortality rate of patients with different levels of serum AFP,CEA,CA125,and CA199 were compared.The predictive value of serum AFP,CEA,CA125,and CA199 for poor prognosis was analyzed using receiver operating characteristic(ROC)curves.Results The serum levels of CA125,CA199,CEA,and AFP in the study group were higher than those in the control group,and the differences were significant(P<0.05).The serum levels of CA125,CA199,CEA,and AFP in the group with good prognosis were lower than those in the group with poor prognosis,and the differences were significant(P<0.05).The recurrence rate,metastasis rate,and mortality rate of the high-level group were higher than those of the low-level group,and the differences were significant(P<0.05).The area under the curve(AUC)of serum AFP,CEA,CA125,and CA199 for predicting poor prognosis in gastric cancer patients were 0.730,0.759,0.689,and 0.791,respectively.The sensitivity and specificity were 67.3%,73.5%,65.3%,73.5%,and 86.2%,78.2%,75.9%,and 86.2%,respectively.The AUC,sensitivity,and specificity of combined detection were 0.906,77.6%,and 92.0%,respectively.The predictive value of joint detection was higher than that of individual detection for each item.Conclusions Serum CA125,CA199,CEA and AFP are abnormally elevated in patients with gastric cancer,so monitoring these indexes has a certain predictive value for poor prognosis of gastric cancer patients.