Significance of combined detection of C-13,pepsinogen and tumor markers in the early diagnosis of gastric cancer
LI Wen-juan;ZHANG Ji-wen;LUO Ming;SHEN Wei-zhong;WU Yong-mei;Department of Gastroenterology,Baoshan District Luodian Hospital of Shanghai;
Objective To explore the significance of C-13 breath test,combined with detection of pepsinogen( PG) and tumor markers( TM) in the early diagnosis of gastric cancer. Methods From March2016 to March 2018,170 patients undergoing gastroscopy for digestive tract symptoms were selected at Baoshan District Luodian Hospital of Shanghai. According to the pathological and gastroscopic results,the patients were divided into gastric cancer group( 79 patients) and general gastritis group( 91 patients). Another 91 healthy individuals were selected as the healthy group in the same period. Patients with gastric cancer were divided into PG positive group( 45 patients) and PG negative group( 34 patients) according to whether PG was positive or not,and were divided into early gastric cancer group( 38 patients) and advanced gastric cancer group( 41 patients) according to pathological biopsy results. C-13 breath test,blood PG and carbohydrate antigen 72-4( CA72-4) were detected in all patients. The levels of serum PG and C-13 breath test were compared among gastric cancer group,normal gastritis group and healthy group and gastric cancer staging and CA72-4 levels were compared between patients with positive expression of PG and patients with negative expression of PG. Results In gastric cancer group,normal gastritis group and healthy group,PGⅠ and PG Ⅰ/PG Ⅱ levels increased gradually,and the difference was statistically significant( P 0. 05). PGⅡ levels were significantly higher in the gastric cancer group and normal gastritis group than in the healthy group( P 0. 05) but the differences in PGⅡ levels were not statistically significant between the gastric cancer group and normal gastritis group( P 0. 05). The positive rate of C-13 breath test was 69. 6%( 55 patients) in the gastric cancer group which was significantly higher than 49. 5%( 45 patients) than in the general gastritis group( P 0. 05). The detection rate of early gastric cancer in PG positive group was 37. 8%( 17 patients) which was significantly lower than 61. 8%( 21 patients) in the PG negative group,but the detection rate was 62. 2%( 28 patients) in the progrerssive gastric cancer group which was significantly higher than that 38. 2%( 13 patients) in PG negative group( all P 0. 05). There was no significant difference in CA72-4 level between PG positive group and PG negative group in patients with early-stage cancer( P 0. 05),but for patients with advanced cancer,CA72-4 level was significantly higher in PG positive group than in PG negative group( P 0. 05). For PG negative group,there was no significant difference in CA72-4 level between patients with early-stage cancer and patients with advanced cancer( P 0. 05),but for PG positive group,CA72-4 level was significantly lower in patients with earlystage cancer than in patients with advanced cancer( P 0. 05). Conclusion Decreased serum PG Ⅰ,positive C-13 breath test results combined with high CA72-4 level have an important warning role in the clinical diagnosis of gastric cancer.
【Fund】： 上海市宝山区科学技术委员会科技创新专项资金项目(17-E-26);; 上海市宝山区罗店医院科研项目(17-A-3);; 上海市宝山区卫生和计划委员会人才培养项目(bswsyq-2017-A13)
【CateGory Index】： R735.2
【CateGory Index】： R735.2