The Clinical Application Study of Tissue Tiam1, Rac1and Serum CA72-4, CEA, CA19-9in Diagnosis of Gastric Cancer and Metastasis
|Course||Clinical Laboratory Science|
|Keywords||gastric cancer Tiam1 Rac1 tumor markers lymph node metastasis|
Objective: The aim of the present study was to measure Tiam1and Rac1mRNA levels in the patient with gastric cancer, explore the two genesexpression in gastric cancer, and explore the two genes express in lymph nodemetastasis cancer. We compared Tiam1and Rac1mRNA levels with serumCA72-4,CEA and CA19-9. through establishment of laboratory Roc curve，We evaluated them application value in distinguishing benign and malignantgastric tumors and in distinguishing lymph node metastasis.Methods: Samples of gastric tissue were obtained from82patients at thefirst hospital of Jilin university from2010to2012. The patients include65inpatients of gastric cancer(37inpatients with lymph node metastasis,28inpatients without lymph node metastasis and), and17patients with benigngastric diseases. The mRNA levels of Tiam1,and Rac1were determined byusing Real-time fluorence quantitative PCR, and the serum tumor marker CEA,CA19-9and CA72-4were measured by electrochemiluminescene. The ROCcurves of Tiam1and Rac1mRNA was established for distinguishing betweenbenign and malignant tumours, as well as to identify the occurrence of lymphnode metastasis. The sensitivity and specificity of the two genes in gastricdiagnosis and identify the metastasis were also studied.. Stastictical analysis were performed using of the software SPSS13.0for Windows, data wasdetermined by a Kruskal-Wallis test, correlation coefficient was determined bySpearman test.Results:1.The expression levels of Tiam1mRNA and Rac1mRNA in gastric tissue:Gastric cancer with lymph node metastasis group was highest expressionlevels(7.26×10~5copies/μl,6.97×10~5copies/μl), gastric cancer without lymphnode metastasis group were4.8×10~5copies/μl,2.91×10~5copies/μl, benigngastric diseases group were1.75×10~4copies/μl,3.92×10~5copies/μl. The valuelevel of gastric cancer with lymph node metastasis group was significantlyhigher than gastric cancer without lymph node metastasis group, gastric cancerwithout lymph node metastasis group was significantly higher than benigngastric diseases group(p<0.05).2.The critical value, sensitivity and specificity of Tiam1and Rac1mRNA:①In order to distinguish benign and malignant gastric tumors, Tiam1and Rac1mRNA of critical value were8.85×10~4copies(2μg) and9.45×10~4copies(2μg), sensitivity were96.9%and95.4%, specificity were88.2%and76.5%, the sensitivity and specificity of the two joint detection were92.3%and92.3%;②In order to distinguish lymph node metastasis and withoutlymph node metastasis. Tiam1and Rac1mRNA of the critical value were6.35×10~5copies(2μg) and3.58×10~5copies(2μg), sensitivity were78.4%and73.0%, specificity also were60.7%, the sensitivity and specificity of the two joint detection were75.7%,71.4%;③17cases gastric tumors group of CA19-9detection threshold level below20.02U/ml and within the reference range highlimit, the two correspond exactly. However,1case patient of CA72-4,1casepatient of CEA results are greater than the critical value and high below thereference range.3.The critical value, sensitivity and specificity of CA72-4, CEA andCA19-9:①To distinguish benign and malignant gastric tumors, CA72-4, CEAand CA19-9of the critical value were2.9U/ml,3.10ng/ml and20.02U/ml,sensitivity were50.8%,36.9%and32.3%, specificity were82.4%,94.1%and88.2%;②To distinguish lymph node metastasis and without lymph nodemetastasis, CA72-4, CEA and CA19-9of the critical value were3.81ng/ml,33.91U/ml and10.9U/ml, sensitivity were27.0%,43.2%and32.4%,specificity were89.4%,89.3%and85.7%.4.Combined Tiam1, Rac1with serum tumor markers(CEA, CA19-9andCA72-4): To distinguish benign and malignant gastric tumors,the highestsensitivity of Joint detection CA72-4+CEA+CA19-9+Rac1is87.5%, thespecificity of joint detection CA72-4+CEA+CA199+Tiam1is100.0%, thesensitivity and specificity of joint detection CA72-4+CEA+CA19-9+Tiam1+Rac1are93.8%and100.0%;②To distinguish lymph node metastasisand without lymph node metastasis, the sensitivity of Joint detection CA724+CEA+CA19-9+Tiam1is73.0%, the specificity of joint detection CA72-4+CEA+CA199+Rac1is82.1%, the sensitivity and specificity of joint detection CA72-4+CEA+CA19-9+Tiam1+Rac1are78.4%and71.4%.5.The expression of Tiam1and Rac1relationship with CA72-4, CEA,CA19-9: The positive rate of Tiam1and Rac1are consistent with CEA,CA19-9, CA72-4, both were positively correlated.6.The level of Tiam1and Rac1have the relationship with biologicalbehavior of gastric cancer: The expression of Tiam1mRNA have a positivecorrelation with tissue differentiation degree, infiltration depth, tumor stagingand vascular invasion(p <0.05); And that Rac1mRNA have a positivecorrelation with tumor size, depth of invasion, related to tumor stage andvascular invasion (p<0.05).Conclusion:1.The expression levels of Tiam1and Rac1mRNA in gastric cancerpatients magnitude higher than benign lesions, lymph node metastasis groupwas higher than that without lymph node metastasis, invasion is higher than thenon-invasion. The level chang of the Tiam1, Rac1which can be used asidentification the benign and malignant gastric lesions, lymph node metastasisand without lymph node metastasis, and invasion degree are one of theIndicator of experimental diagnostic tests.2.CA72-4、CEA、CA19-9have a high degree of sensitivity and specificityto judge benign and malignant gastric tumors, gastric cancer with lymph nodemetastasis and without lymph node metastasis that can be used as identificationthe benign and malignant gastric tumors, Lymph node metastasis for gastric carcinoma and without lymph node metastasis, as one of the Indicator ofexperimental diagnostic tests.3.The sensitivity of Tiam1and Rac1diagnosis are higher,and that thespecificity of CA72-4,CEA,CA19-9are higher.The joint detection of Tiam1、Rac1and CA72-4,CEA,CA19-9improve gastric cancer detection rate.4.17cases benign gastric tumors group of CA19-9critical value iscompletely consistent with reference testing line,1case patient of CA72-4and1case patient of CEA detection results are greater than the critical value，butare lower than the high reference value range, this research will continue tofollow-up and track patients.