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Gastric cancer (gastric cancer, GC) is one of the world's highest incidence of common digestive malignancies, the death rate in the first two. Surgical resection is the primary means to cure early gastric cancer. However, about 2/3 of the patients with a clear diagnosis has entered advanced. Patients with postoperative recurrence and metastasis rate is very high, the recurrence rate can be as high as 50% -70%. The 5-year survival rate was 10% -30%. Chemotherapy is the main treatment for advanced inoperable or postoperative recurrence of gastric cancer patients. Few reports of tumor marker CA19-9, CA72-4, CEA detection for gastric cancer diagnosis, prognosis, evaluation reports are more used to determine efficacy. This study examined patients with gastric cancer plasma CA19-9, CA72-4, CEA levels and the use of oxaliplatin combined with fluorouracil and calcium folinate chemotherapy them, to explore the joint use of CA19-9, CA72-4, CEA as gastric feasibility of chemotherapy and prognosis evaluation. Objective: To study gastric cancer before and after chemotherapy plasma CA19-9, CA72-4, CEA level changes with the objective efficacy of chemotherapy. Methods: Inclusion criteria: Before chemotherapy, CA19-9, CA72-4, CEA any indicator higher than the normal range. Oxaliplatin 130mg/m2ivgtt dl, fluorouracil 450mg/m2ivgtt d1-5, and leucovorin, 200mg/m2 ivgtt d1-5, 3 weeks is a cycle, 2 cycles evaluated the efficacy and adverse reactions. Application electrochemiluminescence assay 52 patients with gastric cancer before chemotherapy after two cycles of chemotherapy plasma CA19-9, of CA72-4, CEA level, a comparative analysis, and analysis of the relationship between the changes of plasma tumor marker levels before and after chemotherapy and clinical data. Results: 52 patients with gastric cancer before chemotherapy plasma CA19-9, CA72-4, CEA normal in 23 cases (44.23%), 16 cases (30.77%), 22 cases (42.31%). Remained normal after chemotherapy were 18 cases, 14 cases, 19 cases of elevated after chemotherapy were 5 cases, 2 cases, 3 cases. Before chemotherapy plasma of CA19-9, CA72-4, CEA levels were 29 cases (55.77%), 36 cases (69.23%) and 30 cases (57.69%). After chemotherapy level changes are as follows: 29 plasma CA19-9 levels before chemotherapy before chemotherapy, after mean were 12.23U/ml, 7.00U/ml after chemotherapy than before chemotherapy significantly lower (P lt; 0.01). 36 plasma CA72-4 levels before chemotherapy before chemotherapy, after mean were 17.16U/ml, 12.00U/ml after chemotherapy than before chemotherapy significantly reduced (P lt; 0.01). 30 cases of plasma CEA levels before chemotherapy before chemotherapy, after mean were 15.36ng/ml, 13.86ng/ml, after chemotherapy than before chemotherapy significantly reduced (P lt; 0.01). CA19-9 changes after chemotherapy and tumor clinical stage. CA19-9 of the 13 patients with stage Ⅲ patients, 23.1% (3/13) downgrade becomes normal, 62.5% (10/16) of the 16 patients with stage Ⅳ downgrade becomes normal (P lt; 0.05). CA72-4 changes with clinical pathological differentiation after chemotherapy, the clinical efficacy. Differentiation of patients in the 22 cases of well-differentiated - CA72-4, 36.4% (8/22) downgrade becomes normal, poorly differentiated - undifferentiated 85.7% (12/14) of the 14 patients were downgraded into a normal (P lt; 0.05); CA72-4 of the 18 cases of chemotherapy patients, 83.3% (15/18) downgrade becomes normal, 27.8% (5/18) of the 18 cases of ineffective chemotherapy patients demotion becomes normal (P lt; 0.05 ). CEA changes related to pathological differentiation after chemotherapy. 17 cases - patients with moderately differentiated and 13 cases of low - undifferentiated CA19-9 levels in patients after chemotherapy, 4 cases (23.5%) and 8 patients (61.5%) were downgraded becomes normal (P lt; 0.05). CA19-9, CA72-4, CEA three tumor markers as a whole, the overall change after their chemotherapy, clinical stage, pathological differentiation, chemotherapy-related difference was statistically significant (P lt; 0.05). Five cases of 52 patients with gastric cancer after chemotherapy complete remission, 17 patients with partial remission, 19 patients with stable progress of 11 cases. Chemotherapy drugs The main side effects were myelosuppression, gastrointestinal reactions and neurotoxicity. Conclusion: chemotherapy allows plasma CA19-9, of CA72-4, CEA level decreased to judge the efficacy of chemotherapy of gastric cancer have some predictive value.
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