Agrawal Saumya, Gupta Amit, Gupta Sweety, Goyal Bela, Siddeek Rohik Anjum T, Rajput Deepak, Chauhan Udit, Kishore Sanjeev, Gupta Manoj, Kant Ravi
Department of Surgery, All India Institute of Medical Sciences, Rishikesh, Uttarakhand, India.
Department of Radiation Oncology, All India Institute of Medical Sciences, Rishikesh, Uttarakhand, India.
J Carcinog. 2020 Jun 27;19:4. doi: 10.4103/jcar.JCar_10_20. eCollection 2020.
Carcinoembryonic antigen (CEA) and carbohydrate antigen 19-9 (CA19-9) have been reported in previous studies to assess the prognosis of gall bladder cancer (GBC) individually and in combination. However, the evidence of utility of preoperative CA 19-9, CEA and carbohydrate antigen 125 (CA 125) in determining the resectability and prognosis of GBC is still lacking. In the present study we correlated the serum levels of tumor markers CA 19-9, CEA and CA 125 individually and combined to determine the resectability and prognosis of the GBC.
Seventy one diagnosed patients of GBC between January 2018 and September 2019 were included in the present study. Serum CA 19-9, CEA and CA 125 were determined by chemiluminescence. Receiver operating characteristic (ROC) curve was used to evaluate the role of tumor markers in determining the resectability of GBC. The Kaplan Meier survival curves were made and log rank analysis was performed to assess the prognostic role of tumor markers in terms of overall median survival.
All the three tumor markers CA19-9, CEA and CA 125 showed high discriminatory power in determining the resectability with respective area under curve of 0.76, 0.68 and 0.78 as determined by ROC. Median survival in patients with high serum CA 19-9, CA 125 was significantly lower than patients with normal serum CA 19-9, CA 125 whereas no significant difference was observed in case of CEA.
The present study suggested that CA 19-9, CEA and CA 125 can predict resectability in GBC and raised levels of CA 19-9 and CA 125 can predict poor prognosis in patients with elevated levels.
既往研究报道过癌胚抗原（CEA）和糖类抗原19-9（CA19-9）可单独或联合用于评估胆囊癌（GBC）的预后。然而，术前CA19-9、CEA和糖类抗原125（CA125）在确定GBC可切除性和预后方面的实用证据仍然缺乏。在本研究中，我们分别及联合分析肿瘤标志物CA19-9、CEA和CA125的血清水平，以确定GBC的可切除性和预后。
本研究纳入了2018年1月至2019年9月期间确诊的71例GBC患者。采用化学发光法测定血清CA19-9、CEA和CA125。采用受试者工作特征（ROC）曲线评估肿瘤标志物在确定GBC可切除性中的作用。绘制Kaplan-Meier生存曲线并进行对数秩分析，以评估肿瘤标志物在总体中位生存方面的预后作用。
所有三种肿瘤标志物CA19-9、CEA和CA125在确定可切除性方面均显示出较高的区分能力，ROC曲线确定的曲线下面积分别为0.76、0.68和0.78。血清CA19-9、CA125水平高的患者中位生存期显著低于血清CA19-9、CA125水平正常的患者，而CEA水平高的患者与正常患者之间未观察到显著差异。
本研究表明，CA19-9、CEA和CA125可预测GBC的可切除性，CA19-9和CA125水平升高可预测水平升高患者的不良预后。
