Division of Medical Oncology, Department of Internal Medicine, The Ohio State University Comprehensive Cancer Center, M365 Starling Loving Hall, 320 West 10th Avenue, Columbus, OH 43210, USA.
Med Oncol. 2012 Dec;29(5):3101-7. doi: 10.1007/s12032-012-0278-9. Epub 2012 Jun 24.
CA19-9 is the most specific biomarker for pancreas cancer. We investigated the prognostic significance of normal (≤ 37 U/mL) versus elevated (>37 U/mL) CA19-9 levels in patients with resected and advanced pancreas cancer. Relevant data were obtained from patients treated for early-stage or advanced pancreatic adenocarcinoma at our institution. Log-rank tests were used to evaluate relationship between CA19-9 and clinical outcomes of interest for both early- and advanced-stage patients. A total of 123 patients were included (Group A: N = 30 stage I/II; Group B: N = 93 stage III/IV). In group A, elevated preoperative CA19-9 was significantly associated with lymph node involvement (p = 0.031), tumor ≥ 3 cm (p = 0.011), and lack of tumor differentiation (p = 0.048). Failure of postoperative CA19-9 to normalize predicted significantly worse DFS (p = 0.021). For group B, elevated baseline CA19-9 was associated with shorter OS on chemotherapy (p = 0.0008) and decline in CA19-9 >25 % with treatment was a significant predictor of improved OS (p = 0.0099). Higher than normal CA19-9 level is an adverse prognostic factor in both early and advanced settings and may prove to be useful in the selection of patients for more aggressive therapy in future trials. CA19-9 level decrease of >25 % predicts improved survival in advanced disease on chemotherapy.
CA19-9 是胰腺癌最具特异性的生物标志物。我们研究了在接受手术治疗的可切除和晚期胰腺癌患者中，CA19-9 正常（≤37 U/mL）与升高（>37 U/mL）水平的预后意义。我们从本机构接受早期或晚期胰腺腺癌治疗的患者中获得了相关数据。对数秩检验用于评估 CA19-9 与早期和晚期患者感兴趣的临床结局之间的关系。共纳入 123 例患者（A 组：N=30 期 I/II 期；B 组：N=93 期 III/IV 期）。在 A 组中，术前升高的 CA19-9 与淋巴结受累（p=0.031）、肿瘤≥3 cm（p=0.011）和肿瘤分化不良（p=0.048）显著相关。术后 CA19-9 未能正常化与显著较差的DFS 相关（p=0.021）。对于 B 组，基线时升高的 CA19-9 与化疗时的 OS 较短相关（p=0.0008），治疗后 CA19-9 下降>25%是 OS 改善的显著预测因子（p=0.0099）。CA19-9 水平升高在早期和晚期均为不良预后因素，可能在未来试验中有助于选择更积极治疗的患者。化疗中 CA19-9 水平下降>25%可预测晚期疾病的生存改善。
