He Zhaopeng, Lu Huimin, Du Xiaojiong, Hu Weiming, Zhaoda Bole Tian
Hepatogastroenterology. 2013 Jun;60(124):900-3. doi: 10.5754/hge12921. Epub 2013 Jan 16.
BACKGROUND/AIMS: The aim of the present study was to evaluate whether CA19-9 level related to the curative resection and prevented unnecessary laparotomy in patients with borderline resectable pancreatic cancer.
Retrospectively, logistic multivariate regression analysis was used to analyze data from 207 patients who underwent laparotomy for planned surgical resection at West China Hospital, during a 5-year period, and performed to identify CA19-9 levels contributing significantly to surgical resection. Inoperable patients were excluded.
Patients with CA19-9 >150U/mL had a frequency of surgical resection 11.7% (14/120) vs. 34.5% (30/87) in those patients with a lower level of CA19-9 (p<0.001). Patients with larger tumor size had a 1.98-fold increased risk of unresectability compared to those with smaller tumor size (p=0.046). Using multivariate analysis adjusted the effects of other factors, high level of CA19-9 and larger tumor size were both considered to be an important risk factor for influencing surgical resection.
CA19-9 should be a good predictor of surgical resection possibility in patients with borderline resectable pancreatic cancer. Furthermore, it is useful in prognosis and optimizing surgical strategy.
背景/目的：本研究旨在评估糖类抗原19-9（CA19-9）水平是否与可切除边缘性胰腺癌患者的根治性切除相关，并避免不必要的剖腹手术。
回顾性地采用逻辑多元回归分析，对5年间在华西医院接受剖腹手术计划行手术切除的207例患者的数据进行分析，以确定对手术切除有显著影响的CA19-9水平。不可手术的患者被排除。
CA19-9>150U/mL的患者手术切除率为11.7%（14/120），而CA19-9水平较低的患者手术切除率为34.5%（30/87）（p<0.001）。肿瘤体积较大的患者与肿瘤体积较小的患者相比，不可切除的风险增加1.98倍（p=0.046）。采用多因素分析调整其他因素的影响后，CA19-9水平高和肿瘤体积大均被认为是影响手术切除的重要危险因素。
CA19-9应是可切除边缘性胰腺癌患者手术切除可能性的良好预测指标。此外，它对预后和优化手术策略也有用。
