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使用癌抗原 19-9、白细胞介素 6 和 YKL-40 预测怀疑胰腺癌患者的可切除性和预后。

Prediction of Unresectability and Prognosis in Patients Undergoing Surgery on Suspicion of Pancreatic Cancer Using Carbohydrate Antigen 19-9, Interleukin 6, and YKL-40.

机构信息

Cancer Society Research Center, Danish Cancer Society.

Department of Surgical Gastroenterology and Transplantation, Rigshospitalet, Copenhagen University Hospital.

出版信息

Pancreas. 2020 Jan;49(1):53-61. doi: 10.1097/MPA.0000000000001466.

DOI:10.1097/MPA.0000000000001466

PMID:31856080

Abstract

OBJECTIVES

The aim was to determine whether serum levels of carbohydrate antigen (CA) 19-9, interleukin 6 (IL-6), and YKL-40 could identify advanced disease and poor prognosis in pancreatic cancer (PC) patients intraoperatively diagnosed with locally advanced or metastatic disease.

METHODS

Two hundred ninety patients were included with preoperative blood samples. Plasma IL-6 and YKL-40 were determined by enzyme-linked immunosorbent assays.

RESULTS

Interleukin 6 was elevated in patients with unresectable PC compared with resectable PC (P = 0.03). Carbohydrate antigen 19-9 and YKL-40 were similar. Patients with resectable tumors and greater than median preoperative CA 19-9, IL-6, and YKL-40 had shorter overall survival than patients with low levels (CA 19-9: hazard ratio [HR], 1.79; 95% confidence interval [CI], 1.13-2.83; P = 0.01; IL-6: HR, 1.83; 95% CI, 1.20-2.78; P = 0.01; YKL-40: HR, 1.60; 95% CI, 1.02-2.49; P = 0.04). Patients with resectable tumors and 2 or 3 high biomarker levels had significantly reduced overall survival compared with patients with low levels (2 high: HR, 2.97; 95% CI, 1.44-6.10; P = 0.00; 3 high: HR, 3.10; 95% CI, 1.45-6.65; P = 0.00).

CONCLUSIONS

Preoperative levels of CA 19-9, IL-6, and YKL-40 may be useful to identify a subgroup of PC patients with poor prognosis.

摘要

目的

旨在确定在术中诊断为局部晚期或转移性疾病的胰腺癌（PC）患者中，血清碳水化合物抗原（CA）19-9、白细胞介素 6（IL-6）和 YKL-40 水平是否可以识别晚期疾病和不良预后。

方法

纳入 290 例术前有血样的患者。通过酶联免疫吸附试验测定血浆 IL-6 和 YKL-40。

结果

与可切除 PC 患者相比，不可切除 PC 患者的白细胞介素 6 升高（P=0.03）。CA19-9 和 YKL-40 相似。与低水平患者相比，具有可切除肿瘤且术前 CA19-9、IL-6 和 YKL-40 高于中位数的患者总生存期更短（CA19-9：风险比[HR]，1.79；95%置信区间[CI]，1.13-2.83；P=0.01；IL-6：HR，1.83；95%CI，1.20-2.78；P=0.01；YKL-40：HR，1.60；95%CI，1.02-2.49；P=0.04）。具有可切除肿瘤且 2 种或 3 种高生物标志物水平的患者总生存期明显低于低水平患者（2 种高：HR，2.97；95%CI，1.44-6.10；P=0.00；3 种高：HR，3.10；95%CI，1.45-6.65；P=0.00）。