RESUMO
Objective:To study the relationship between the expression of tumor markers and radical resection in patients with gastric cancer.Methods:The medical records of gastric cancer patients undergoing surgery in Department of Gastrointestinal Surgery, Puji District, Dongguan People′s Hospital Affiliated to Southern Medical University from June 2018 to December 2019 were retrospectively analyzed, and 136 patients were selected.Collected patient data, including general information, the expression levels of tumor markers carcinoembryonic antigen(CEA), carbohydrate antigen 19-9(CA19-9), carbohydrate antigen 72-4(CA72-4), and the surgical method used.The relationship between the expression of tumor markers and radical resection was observed.Results:There was no statistically significant difference in the radical resection rate of gastric cancer in different genders, ages, and locations of gastric cancer (all P>0.05). TNM classification (tumor node metastasis classification) stage III patients had a lower radical resection rate (63.3%(38/60)) than stage I (100%(27/27)) and II (100%(49/49)) (χ 2=58.166 and 81.208, P<0.001). The radical resection rate of CEA(+ ) patients (47.8%(44/92)) was lower than that of CEA(-) patients (90.9%(40/44))(χ 2=23.394, P<0.001). The radical resection rate of CA19-9(+ ) patients (47.7%(42/88)) was lower than that of CA19-9(-) patients(87.5%(42/48))(χ 2=20.804, P<0.001). The radical resection rate of CA72-4(+ ) patients (54.3%(51/94)) was lower than that of CA72-4(-) patients (78.6%(33/42)) (χ 2=7.268, P=0.007). The variables with P<0.1 in univariate analysis were included in the logistic regression model, including 4 variables including TNM stage, CEA, CA19-9, and CA72-4.The results showed that TNM staging ( OR=1.169, 95% CI=0.925-1.634, P=0.001), CEA ( OR=1.067, 95% CI=1.364-4.338, P=0.024), CA19-9( OR=3.012, 95% CI=1.679-6.317, P=0.007), and CA72-4 were independent risk factors for radical resection( OR=5.364, 95% CI=0.675-3.224, P=0.004). The number of positive expressions of tumor markers was negatively correlated with the radical resection rate ( r=-0.621, P<0.05). The expression levels of CEA, CA19-9, and CA72-4 in patients with radical resection were 75.36(3.76, 198.20)μg/L, 152.76(34.81, 241.09)kU/L, 126.60(4.01, 218.07)kU/L, respectively.The expression levels of CEA, CA19-9, and CA72-4 in the radically resected patient group were 173.65(120.78, 254.87) μg/L, 255.88(102.45, 395.11) kU/L, 201.71(79.15, 325.92)kU/L.The expression level of CEA, CA19-9, CA72-4 in the group with radical resection were lower than that in the group with no radical resection, and the difference was statistically significant (the Z values were 10.672, 8.945, 9.862, all P<0.001). ROC curve showed that AUC of CEA, CA19-9 and CA72-4 were 0.627, 0.714 and 0.768, respectively.The best cut-off value of CA72-4 was 87.62 kU/L, the sensitivity was 88.1% (74/84) and the specificity was 90.4% (47/52). Conclusion:The expression levels and number of tumor markers CEA, CA19-9, CA72-4 in patients with gastric cancer were correlated with the risk of radical resection.