Prediction of Recurrence by Serum CA724 and PG Ⅰ/Ⅱ Ratio in Laparoscopic-Assisted Distal Gastrectomy
ZHANG Lingling
GE Qin
YU Xiaoxiao
CAO Xiaoli
Abstract：Objective To analyze the predictive value of serum carbohydrate antigen(CA724)and pepsinogen(PG)Ⅰ/PG Ⅱ ratio expression for recurrence after laparoscopic-assisted distal gastrectomy(LADG).Methods A retrospective cohort study was conducted,and 127 gastric cancer patients admitted to the North Hospital of Nantong Tumor Hospital from June 2021 to May 2023 were selected.The patients were divided into a recurrence group(n=45)and a non-recurrence group(n=82)based on recurrence events within 2 years of postoperative follow-up.The preoperative serum CA724,PG Ⅰ/PG Ⅱ ratio,and general clinical data of the two groups were compared.Multivariate Cox proportional hazards regression was used to analyze the influencing factors of recurrence after gastric cancer patients LADG,and ROC curve was used to analyze the predictive value of CA724 and PG Ⅰ/PG Ⅱ ratio for recurrence after gastric cancer patients LADG.Results Among 127 patients with gastric cancer,a total of 45 experienced recurrence events,including 28 cases of local recurrence and 17 cases of distant metastasis,with a cumulative recurrence rate of approximately 35.43%(45/127).There were statistically significant differences in TNM staging and histopathological grading between the two groups(P<0.01).The levels of serum CA724,GAS-17,and PG Ⅱ in the recurrence group were higher than those in the non-recurrence group,and the levels of PG Ⅰ and PG Ⅰ/PG Ⅱ ratio were lower than those in the non-recurrence group,with statistically significant differences[(32.53±5.75)U/mL vs(26.25±5.16)U/mL,P<0.01;(6.75±1.83)pmol/L vs(5.62±1.57)pmol/L,P<0.01;(24.25±4.64)μg/L vs(22.14±4.27)μg/L,P<0.05;(68.42±8.62)μg/L vs(73.65±8.24)μg/L,P<0.01;2.82±0.37 vs 3.32±0.43,P<0.01].Multivariate Cox proportional hazards regression analysis showed that TNM stage Ⅱ-Ⅲ,histopathological grade G2 and G3,high serum expression of CA724 and GAS-17,and decreased PG Ⅰ/PG Ⅱ ratio were risk factors for recurrence in gastric cancer patients after LADG(HR=3.188,95%CI:1.186-8.569,P=0.022;HR=3.405,95%CI:1.277-9.076,P=0.014;HR=5.895,95%CI:1.914-18.158,P=0.002;HR=8.013,95%CI:2.717-23.627,P<0.001;HR=1.067,95%CI:1.016-1.120,P=0.010;HR=1.242,95%CI:1.034-1.491,P=0.020;HR=0.309,95%CI:0.146-0.652,P=0.002).ROC curve analysis showed that the AUC of serum CA724 and PG Ⅰ/PG Ⅱ ratio for predicting the recurrence of gastric cancer patients after LADG was 0.795 and 0.807,respectively.The AUC of the combined prediction of the two for predicting the recurrence of gastric cancer patients after LADG was 0.885,which was relatively high.However,there was no statistically significant difference in the AUC predicted by serum CA724 and PG Ⅰ/PG Ⅱ ratio alone compared with the AUC predicted by the combination of the two(P>0.05).Pearson correlation analysis indicated a negative correlation between serum CA724 level and PG Ⅰ/PG Ⅱ ratio in gastric cancer patients(r=-0.262,P<0.05).Conclusion The recurrence after LADG in gastric cancer patients is related to the increased serum CA724 expression and the decreased PG Ⅰ/PG Ⅱ ratio,and the two indicators may have a coordinated effect.Preoperative detection of serum CA724 and PG Ⅰ/PGⅡ ratio has certain predictive value for recurrence within 2 years after surgery.
Keywords：laparoscopy-assisted distal gastrectomycarbohydrate antigen 724pepsinogenⅠ/pepsinogen Ⅱ ratiorecurrence
Publication Date：2025-11-20
Online Publishing Date：2025-11-24(First online date of this platform, not the publication date of the document)
Pages：6( 50-55 )