Suzuki Shuji, Shimoda Mitsugi, Shimazaki Jiro, Maruyama Tsunehiko, Oshiro Yukio, Nishida Kiyotaka, Sahara Yatsuka, Nagakawa Yuichi, Tsuchida Akihiko
Department of Gastroenterological Surgery, Ibaraki Medical Center, Tokyo Medical University, Ibaraki, Japan,
Department of Gastroenterological Surgery, Ibaraki Medical Center, Tokyo Medical University, Ibaraki, Japan.
Eur Surg Res. 2018;59(5-6):329-338. doi: 10.1159/000494382. Epub 2018 Nov 19.
We aimed to evaluate the use of preoperative clinicophysiological parameters as predictive risk factors for early recurrence of pancreatic ductal adenocarcinoma (PDAC) after curative resection.
A total of 260 patients who underwent pancreatic resection for PDAC between 2007 and 2015 were examined retrospectively. We divided the patients into those with early recurrence (within 6 months; group A, n = 52) and those with relapse within ≥6 months or without recurrence (group B, n = 208). Data regarding clinicophysiological parameters were analyzed as predictors of disease-free survival (DFS). These factors were analyzed by χ2 tests on univariate analysis and Cox proportional hazard models on multivariate analyses. Kaplan-Meier survival curves were generated using log-rank tests.
Groups A and B had significantly different preoperative carbohydrate antigen 19-9 (CA19-9) levels, carcinoembryonic antigen (CEA) levels, and curability. Univariate and multivariate analysis showed that CA19-9 and CEA were independent prognostic factors for early recurrence. Patients with CA19-9 levels > 124.65 U/mL had significantly shorter DFS than those with lower levels, as did patients with CEA levels > 4.45 ng/mL.
Our results show that elevated CA19-9 (> 124.65 U/mL) and CEA (> 4.45 ng/mL) were independent predictors of early recurrence after pancreatic resection in PDAC patients.
我们旨在评估术前临床生理参数作为胰腺导管腺癌（PDAC）根治性切除术后早期复发的预测风险因素的作用。
回顾性研究了2007年至2015年间260例行PDAC胰腺切除术的患者。我们将患者分为早期复发组（6个月内；A组，n = 52）和复发时间≥6个月或未复发组（B组，n = 208）。分析临床生理参数数据作为无病生存期（DFS）的预测指标。这些因素在单因素分析中通过χ2检验进行分析，在多因素分析中通过Cox比例风险模型进行分析。使用对数秩检验生成Kaplan-Meier生存曲线。
A组和B组术前糖类抗原19-9（CA19-9）水平、癌胚抗原（CEA）水平和可切除性有显著差异。单因素和多因素分析表明，CA19-9和CEA是早期复发的独立预后因素。CA19-9水平> 124.65 U/mL的患者DFS明显短于水平较低的患者，CEA水平> 4.45 ng/mL的患者也是如此。
我们的结果表明，CA19-9（> 124.65 U/mL）和CEA（> 4.45 ng/mL）升高是PDAC患者胰腺切除术后早期复发的独立预测因素。
