Wang Jun-Ke, Hu Hai-Jie, Shrestha Anuj, Ma Wen-Jie, Yang Qin, Liu Fei, Cheng Nan-Sheng, Li Fu-Yu
Department of Biliary Surgery, West China Hospital of Sichuan University, Chengdu, Sichuan Province, China.
Department of General Surgery, Gandaki Medical College, Pokhara, Nepal.
Oncotarget. 2017 Jul 11;8(28):45335-45344. doi: 10.18632/oncotarget.17336.
To investigate the predictive values of preoperative and postoperative serum CA19-9 levels on survival and other prognostic factors including early recurrence in patients with resectable hilar cholangiocarcinoma.
In univariate analysis, increased preoperative and postoperative CA19-9 levels in the light of different cut-off points (37, 100, 150, 200, 400, 1000 U/ml) were significantly associated with poor survival outcomes, of which the cut-off point of 150 U/ml showed the strongest predictive value (both P < 0.001). Preoperative to postoperative increase in CA19-9 level was also correlated with poor survival outcome (P < 0.001). In multivariate analysis, preoperative CA19-9 level > 150 U/ml was significantly associated with lymph node metastasis (OR = 3.471, 95% CI 1.216-9.905; P = 0.020) and early recurrence (OR = 8.280, 95% CI 2.391-28.674; P = 0.001). Meanwhile, postoperative CA19-9 level > 150 U/ml was also correlated with early recurrence (OR = 4.006, 95% CI 1.107-14.459; P = 0.034).
Ninety-eight patients who had undergone curative surgery for hilar cholangiocarcinoma between 1995 and 2014 in our institution were selected for the study. The correlations of preoperative and postoperative serum CA19-9 levels on the basis of different cut-off points with survival and various tumor factors were retrospectively analyzed with univariate and multivariate methods.
In patients with resectable hilar cholangiocarcinoma, serum CA19-9 predict survival and early recurrence. Patients with increased preoperative and postoperative CA19-9 levels have poor survival outcomes and higher tendency of early recurrence.
探讨术前及术后血清CA19-9水平对可切除肝门部胆管癌患者生存及包括早期复发在内的其他预后因素的预测价值。
单因素分析中，根据不同截断点（37、100、150、200、400、1000 U/ml），术前及术后CA19-9水平升高均与较差的生存结局显著相关，其中截断点为150 U/ml时预测价值最强（均P<0.001）。术前至术后CA19-9水平升高也与较差的生存结局相关（P<0.001）。多因素分析中，术前CA19-9水平>150 U/ml与淋巴结转移（OR=3.471，95%CI 1.216-9.905；P=0.020）及早期复发（OR=8.280，95%CI 2.391-28.674；P=0.001）显著相关。同时，术后CA19-9水平>150 U/ml也与早期复发相关（OR=4.006，95%CI 1.107-14.459；P=0.034）。
选取1995年至2014年在本机构接受肝门部胆管癌根治性手术的98例患者进行研究。采用单因素和多因素方法回顾性分析基于不同截断点的术前及术后血清CA19-9水平与生存及各种肿瘤因素的相关性。
在可切除肝门部胆管癌患者中，血清CA19-9可预测生存及早期复发。术前及术后CA19-9水平升高的患者生存结局较差且早期复发倾向较高。
