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胃癌患者血清胃泌素释放肽前体、鳞癌相关抗原和糖类抗原72-4的变化及意义

Changes and significance of serum pro-gastrin-releasing peptide, squamous cell carcinoma-related antigen and carbohydrateantigen 72-4 in patients with gastric cancer

    摘要
  • 摘要:
    目的 探讨胃癌患者血清胃泌素释放肽前体(ProGRP)、鳞癌相关抗原(SCC)及糖类抗原72-4(CA72-4)水平变化及临床意义。
    方法 选取68例胃癌患者(胃癌组)、37例胃部良性病变患者(胃部良性病变组)、30例健康受试者(非胃部疾病组)作为研究对象。比较3组研究对象入院时血清ProGRP、SCC、CA72-4水平; 分析胃癌组患者血清ProGRP、SCC、CA72-4水平与病理参数的关系; 对出院后胃癌组患者随访24个月，采用多因素Logistic回归分析明确胃癌患者随访预后的影响因素，绘制受试者工作特征(ROC)曲线并计算曲线下面积(AUC), 分析血清ProGRP、SCC、CA72-4对胃癌患者随访期间死亡的预测效能。
    结果 胃癌组血清ProGRP、SCC、CA72-4水平高于胃部良性病变组和非胃部疾病组，胃部良性病变组血清ProGRP、CA72-4水平高于非胃部疾病组，差异有统计学意义(P < 0.05); 胃癌组中, TNM分期为Ⅲ~Ⅳ期、组织学分级为中低分化、有淋巴结转移患者血清ProGRP、CA72-4水平分别高于Ⅰ~Ⅱ期、高分化、无淋巴结转移患者，组织学分级为中低分化患者血清SCC水平高于高分化患者，差异有统计学意义(P < 0.05)。随访24个月，胃癌组存活49例(存活组)、死亡19例(死亡组)，死亡组患者入院时血清ProGRP、SCC、CA72-4水平均高于存活组，差异有统计学意义(P < 0.05)。多因素Logistic回归分析结果显示，血清ProGRP、SCC、CA72-4均为胃癌患者随访预后的独立影响因素(P < 0.05); 血清ProGRP、SCC、CA72-4对胃癌患者随访期间死亡均有良好的预测效能(AUC=0.766、0.705、0.828), 且三者联合的预测效能更佳(AUC=0.899)。
    结论 胃癌患者血清ProGRP、SCC、CA72-4水平异常升高(与TNM分期、组织学分级、淋巴结转移状态有关)，三者联合检测对患者随访期间死亡具有很好的预测效能。

     

    Abstract:
    Objective To investigate the changes and clinical significance of serum pro-gastrin-releasing peptide (ProGRP), squamous cell carcinoma-related antigen (SCC), and carbohydrate antigen 72-4 (CA72-4) levels in patients with gastric cancer.
    Methods A total of 68 patients with gastric cancer (gastric cancer group), 37 patients with benign gastric lesions (benign gastric lesion group), and 30 healthy subjects (non-gastric disease group) were selected as the study participants. Serum ProGRP, SCC, and CA72-4 levels were compared among the three groups on admission. The relationships of serum ProGRP, SCC, and CA72-4 levels with pathological parameters were analyzed in the gastric cancer group. Patients in the gastric cancer group were followed up for 24-month after discharge. Multivariate Logistic regression analysis was used to identify the influencing factors of prognosis in gastric cancer patients. Receiver operating characteristic (ROC) curves were plotted and the area under the curve (AUC) was calculated to analyze the predictive value of serum ProGRP, SCC, and CA72-4 for death during follow-up in gastric cancer patients.
    Results The serum levels of ProGRP, SCC, and CA72-4 in the gastric cancer group were higher than those in the benign gastric lesion group and the non-gastric disease group, and the serum levels of ProGRP and CA72-4 in the benign gastric lesion group were higher than those in the non-gastric disease group (P < 0.05). In the gastric cancer group, patients with TNM stage Ⅲ to Ⅳ, moderately-lowly differentiated histological grade, and lymph node metastasis had higher serum levels of ProGRP and CA72-4 than those with stage Ⅰto Ⅱ, high differentiation, and no lymph node metastasis. Patients with moderately-lowly differentiated histological grade had higher serum levels of SCC than those with high differentiated histological grade (P < 0.05). After 24 months of follow-up, 49 patients survived (survival group) and 19 patients died (death group) in the gastric cancer group. The serum levels of ProGRP, SCC, and CA72-4 in the death group were higher than those in the survival group on admission (P < 0.05). Multivariate Logistic regression analysis showed that serum ProGRP, SCC, and CA72-4 were independent influencing factors for the prognosis of gastric cancer patients (P < 0.05). Serum ProGRP, SCC, and CA72-4 had good predictive efficacy for death during follow-up in gastric cancer patients (AUC=0.766, 0.705, 0.828), and their combined predictive efficacy was better (AUC=0.899).
    Conclusion The serum levels of ProGRP, SCC, and CA72-4 that are related to TNM stage, histological grade, and lymph node metastasis in patients with gastric cancer are abnormally elevated, and their combined detection has good predictive efficacy for death during follow-up.

     

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