Application of AFP,CEA,CA125,and CA19-9 in the diagnosis and prognosis evaluation of peritoneal metastasis in gastric cancer
Dong Hongxu
Zhang Yanbin
Yang Fan
Li Yang
Yan Guojun
Abstract：Objective To explore the application of alpha-fetoprotein(AFP),carcinoembryonic antigen(CEA),carbohydrate antigen 125(CA125),and carbohydrate antigen 19-9(CA19-9)in the diagnosis and prognosis evaluation of peritoneal me-tastasis in gastric cancer.Methods A total of 102 gastric cancer patients who underwent surgical treatment at Beijing Shiji-tan Hospital,Capital Medical University from January 2020 to January 2021 were selected as the research participants.Ac-cording to intraoperative evaluation results,26 patients with peritoneal metastasis were included in the metastasis group,and 76 patients without peritoneal metastasis were included in the non-metastasis group.The general clinical data and preop-erative serum levels of AFP,CEA,CA125,and CA19-9 were compared between the two groups.Receiver operating charac-teristic(ROC)curves were plotted to analyze the diagnostic efficacy of preoperative AFP,CEA,CA125,and CA19-9 sin-gle-item detection and combined detection for peritoneal metastasis in gastric cancer,and to obtain the optimal cutoff value,area under the curve(AUC),sensitivity,specificity,and other data.Cox stepwise regression analysis was adopted to ana-lyze the risk factors for the prognosis of gastric cancer patients with peritoneal metastasis.Results No statistically signifi-cant differences were observed in gender composition,age,tumor location,and tumor histological grade between the two groups(P＞0.05).The TNM staging grade of the metastasis group was significantly higher than that of the non-metastasis group(P＜0.05).The preoperative serum levels of AFP,CEA,CA125,and CA19-9 in the metastasis group were signifi-cantly higher than those in the non-metastasis group(P＜0.05).The ROC curve analysis results showed that the sensitivity and specificity of preoperative AFP,CEA,CA125,and CA19-9 single-item detection and combined detection for peritoneal metastasis in gastric cancer were 88.50％and 85.50％,92.30％and 84.20％,88.50％and 81.60％,84.60％and 82.90％,and 96.20％and 84.20％,respectively.The AUC values of preoperative AFP,CEA,CA125,CA19-9 single-i-tem detection and combined detection for peritoneal metastasis in gastric cancer were 0.866,0.893,0.848,0.843,and 0.969,respectively.The results of Cox stepwise regression analysis indicated that elevated preoperative serum levels of AFP,CEA,CA125,and CA19-9 were independent risk factors for the overall survival of gastric cancer patients with perito-neal metastasis(P＜0.05).Conclusion Preoperative serum levels of AFP,CEA,CA125,and CA19-9 are closely correlated with peritoneal metastasis in gastric cancer,and combined detection is valuable in its diagnosis.Elevated preoperative serum levels of AFP,CEA,CA125,and CA19-9 are independent risk factors for the overall survival of gastric cancer patients with peritoneal me-tastasis,and these indicators can be monitored clinically to assist in disease assessment and prognosis prediction.
Keywords：Gastric cancerPeritoneal metastasisAlpha-fetoproteinCarcinoembryonic antigenCarbohydrate antigen 125Carbohydrate antigen 19-9
Publication Date：2023-12-28
Online Publishing Date：2025-08-15(First online date of this platform, not the publication date of the document)
Pages：6( 70-75 )