Cai Wen-Ke, Lin Jia-Ji, He Gong-Hao, Wang Hua, Lu Jun-Hua, Yang Guang-Shun
Department of Cardio-Thoracic Surgery, Kunming General Hospital of Chengdu Military Region Kunming, China.
Department of Neurology, Tangdu Hospital of Fourth Military Medical University Xi'an, China.
Int J Clin Exp Pathol. 2014 Oct 15;7(11):7890-8. eCollection 2014.
To investigate the appropriate cutoff point of CA19-9 for prognosis and other potential prognostic factors that may affect survival of patients with hilar cholangiocarcinoma (HC) after radical surgery. 168 patients who had undergone radical surgery for hilar cholangiocarcinoma and resultant macroscopic curative resection (R0 and R1) were discreetly selected for analyses. Categorized versions were used in univariate model to determine the appropriate cutoff point of CA19-9. CA19-9 and other clinicopathologic factors were analyzed for influence on survival by univariate and multivariate methods. The strongest univariate predictor among the categorized preoperative CA19-9 measures was CA19-9 less than 150 IU/L (P = 0.000). In univariate analysis, tumor size, Bismuth-Corlette classification, portal vein invasion, Lymph node metastasis, resection margin and preoperative CA19-9 levels were identified as significant prognostic factors. In multivariable analysis, lymph node metastasis, resection margin and preoperative CA19-9 levels were independent prognostic factors. our results demonstrated that preoperative CA19-9 levels was also an independent prognostic factor for hilar cholangiocarcinoma, and the most discriminative cutoff point of CA19-9 for prognosis proved to be at 150 U/ml.
为研究肝门部胆管癌(HC)根治性手术后CA19-9用于预后评估的合适临界值以及其他可能影响患者生存的潜在预后因素。谨慎选取168例行肝门部胆管癌根治性手术且获得宏观治愈性切除(R0和R1)的患者进行分析。在单因素模型中使用分类变量来确定CA19-9的合适临界值。采用单因素和多因素方法分析CA19-9及其他临床病理因素对生存的影响。术前CA19-9分类测量中最强的单因素预测指标是CA19-9低于150 IU/L(P = 0.000)。在单因素分析中,肿瘤大小、Bismuth-Corlette分型、门静脉侵犯、淋巴结转移、切缘及术前CA19-9水平被确定为显著预后因素。在多因素分析中,淋巴结转移、切缘及术前CA19-9水平是独立预后因素。我们的结果表明,术前CA19-9水平也是肝门部胆管癌的独立预后因素,且CA19-9用于预后评估的最具鉴别力的临界值为150 U/ml。