Takahara Naminatsu, Nakai Yousuke, Isayama Hiroyuki, Sasaki Takashi, Saito Kei, Noguchi Kensaku, Suzuki Tatsunori, Nakamura Tomoka, Sato Tatsuya, Ishigaki Kazunaga, Hakuta Ryunosuke, Takeda Tsuyoshi, Uchino Rie, Mizuno Suguru, Kogure Hirofumi, Tada Minoru, Koike Kazuhiko
Department of Gastroenterology, Graduate School of Medicine, The University of Tokyo, 7-3-1, Hongo, Bunkyo-ku, Tokyo, 113-8655, Japan.
Department of Gastroenterology, Graduate School of Medicine, Juntendo University, Tokyo, Japan.
Cancer Chemother Pharmacol. 2017 Dec;80(6):1105-1112. doi: 10.1007/s00280-017-3456-9. Epub 2017 Oct 16.
The role of carbohydrate antigen 19-9 (CA19-9) kinetics in patients with biliary tract cancer (BTC) receiving chemotherapy remains to be elucidated.
A total of 185 advanced or recurrent BTC patients receiving a first line chemotherapy between January 2006 and March 2016, were retrospectively studied. Serum CA19-9 was measured at baseline and after two cycles of chemotherapy, and patients were categorized based on CA19-9 response: CA19-9 decrease group (≥ 30% decrease), stable group (< 30% decrease and < 20% increase) and increase group (≥ 20% increase). The associations of CA19-9 response with radiological tumor response, progression-free survival (PFS) and overall survival (OS) were investigated.
There was a statistically significant association between CA19-9 response and radiological tumor responses (p < 0.001). The median PFS and OS were significantly different among three groups according to CA19-9 response: PFS of 8.0, 5.7 and 3.5 months in CA19-9 decrease, stable and increase groups (p < 0.001) and OS of 18.8, 16.0 and 7.5 months in CA19-9 decrease, stable and increase groups, respectively (p < 0.001). Multivariate analyses showed that CA19-9 response was prognostic both of OS and PFS in addition, to CA19-9 at baseline, and performance status.
CA19-9 kinetics after the first two cycles of a first line chemotherapy was a prognostic factor for OS and PFS in patients with advanced and recurrent BTC.
探讨糖类抗原19-9（CA19-9）动力学变化在接受化疗的胆管癌（BTC）患者中的作用。
回顾性研究2006年1月至2016年3月期间接受一线化疗的185例晚期或复发性BTC患者。在基线和化疗两个周期后检测血清CA19-9，并根据CA19-9反应将患者分类：CA19-9降低组（降低≥30%）、稳定组（降低<30%且升高<20%）和升高组（升高≥20%）。研究CA19-9反应与放射学肿瘤反应、无进展生存期（PFS）和总生存期（OS）的相关性。
CA19-9反应与放射学肿瘤反应之间存在统计学显著相关性（p<0.001）。根据CA19-9反应，三组患者的中位PFS和OS有显著差异：CA19-9降低组、稳定组和升高组的PFS分别为8.0个月、5.7个月和3.5个月（p<0.001），OS分别为18.8个月、16.0个月和7.5个月（p<0.001）。多因素分析显示，除了基线CA19-9和体能状态外，CA19-9反应对OS和PFS均具有预后意义。
一线化疗前两个周期后的CA19-9动力学变化是晚期和复发性BTC患者OS和PFS的预后因素。
