THE DIAGNOSTIC VALUE OF SERUM PEPSINOGEN, GASTRIN 17, CARBOHYDRATE ANTIGEN 72-4 AND THYMIDINE KINASE 1 IN EARLY GASTRIC CANCER

Dongya Chen¹, Xiaoyan Yang², Meixia Huang¹, Xueying Lai³, Yuqin Wang⁴, Zhonghui Guo^2,*

¹Department of Health Management Center, Guangzhou Panyu District Central Hospital, Guangzhou, 511400, China - ²Department of Laboratory, Guangzhou Panyu District Central Hospital, Guangzhou, 511400, China - ³Department of Digestive Center, Guangzhou Panyu District Central Hospital, Guangzhou, 511400, China

Objective: To analyze the diagnostic value of serum pepsinogen (PG), gastrin 17 (G-17), carbohydrate antigen 72-4 (CA72-4) and thymidine kinase 1 (TK1) for early gastric cancer (GC). 

Methods: One-hundred twenty-eight patients with gastric disease admitted to our hospital from January 2019 to January 2020 participated in this study. Sixty-nine of these patients had gastric cancer (GC), and 59 patients had atrophic gastritis (CAG). Forty healthy people who were examined in the physical examination center of our hospital during the same period were selected as the control group. All study participants had 4ml of fasting venous blood drawn in the early morning. The blood was drawn from the GC and CAG groups within 24 hours of admission and from the healthy people during their physical examination. The serum PG, G-17 and TK1 levels of the subjects in each group were detected via enzyme-linked immunosorbent assay, and the serum CA72-4 levels in each group were detected by electrochemiluminescence. The serum PG, G-17, CA72-4 and TK1 levels in each group were compared using multivariate logistic regression, and ROC curves were used to analyze the abilities of PG, G-17, CA72-4 and TK1 alone and in combination to diagnose GC. 

Results: The levels of serum PG Ⅰ in the CAG and GC groups were significantly lower than those in the control group. The levels of G-17, CA72-4 and TK1 for the CAG and GC groups were significantly higher than those in the control group. The serum PG Ⅰ levels in the GC group were significantly lower than those in the CAG group, and the levels of G-17, CA72-4 and TK1 for the GC group were significantly higher than the CAG group (P<0.05). Furthermore, the serum PG Ⅰ level of patients in the moderately and highly differentiated adenocarcinoma group was significantly lower than that of the poorly differentiated adenocarcinoma group, and the levels of G-17, CA72-4 and TK1 for this group were significantly higher than those in the poorly differentiated adenocarcinoma group. In the highly differentiated adenocarcinoma group, the serum PG Ⅰ level was significantly lower than that for the moderately differentiated adenocarcinoma group, and the levels of G-17, CA72-4 and TK1 for this group were significantly higher than those in the moderately differentiated adenocarcinoma group (P<0.05). Multivariate logistic regression analysis showed that PG Ⅰ, PG Ⅱ, G-17, CA72-4 and TK1 were all influencing factors in the onset of GC (P<0.01). The ROC curve analysis revealed that the AUC of PG Ⅰ for diagnosing GC was 0.815, with a sensitivity of 83.15% and specificity of 76.68%; the AUC of PG Ⅱ for diagnosing GC was 0.832, with a sensitivity of 80.14% and specificity of 85.21%. The AUC of G-17 for diagnosing GC was 0.716, with a sensitivity of 70.25% and specificity of 72.89%; the AUC of CA72-4 for diagnosing GC was 0.758, with a sensitivity of 76.43% and specificity of 72.89%; the AUC of TK1 for diagnosing GC was 0.685, with a sensitivity of 68.31% and specificity of 63.58%. Finally, the AUC of the combination for diagnosing GC was 0.918, with a sensitivity of 93.58% and specificity of 89.37%. 

Conclusion: The abnormal expressions of PG, G-17, CA72-4 and TK1 in the serum of patients with GC are all influencing factors in the onset of GC and have certain values in the diagnosis of early GC, while the combination of these abnormal expressions is of higher value in detecting GC.