Xiao Jianchun, Wang Li, Hong Tao, Li Binglu, Liu Wei, Qu Qiang, Zheng Chaoji, He Xiaodong
Department of General Surgery, Peking Union Medical College Hospital, Beijing 100730, China.
J Oncol. 2021 Feb 23;2021:5829893. doi: 10.1155/2021/5829893. eCollection 2021.
Incidence of biliary tract cancers (BTCs) in China is high, and surgery is the only curative option. Preoperative CA19-9 has been identified as a predictor for survival in patients with resectable BTCs, but more potential predictors need to be studied. This retrospective study aimed to establish the prognostic significance of CA19-9/TBIL ratio (CTR) in patients with BTCs.
A retrospective analysis was performed in patients who were diagnosed with BTCs and received surgical resection between 2013 and 2018 at PUMCH. Demographic and clinical parameters were collected. Preoperative CA19-9 and CTR were classified as elevated (>58.6 and >0.83) according to the receiver operating characteristic (ROC) analysis. Demographic and clinical parameters were compared between the groups using Student's -test, chi-square, or Fisher's exact test. Survival analysis was performed by the Kaplan-Meier methods, and the relationship between variables and survival was assessed by the log-rank test. Cox regression analysis was conducted to identify potential risk factors for overall survival.
In total, 109 participants were involved in the final analysis. The overall survival rate was 18.0% at 5 years, with a median survival duration of 1.58 years. The Kaplan-Meier analysis indicated that higher CTR was associated with shorter OS (15 vs. 50, < 0.01). Univariate survival analysis identified TNM staging, CA19-9, and CTR as statistically significant prognostic factors. In a multiple Cox analysis, only CTR was proved as a significantly independent prognostic factor.
CTR acts as an independent prognostic predictor for patients with biliary tract cancer.
中国胆道癌（BTCs）的发病率很高，手术是唯一的治愈选择。术前CA19-9已被确定为可切除BTCs患者生存的预测指标，但仍需研究更多潜在的预测指标。这项回顾性研究旨在确定CA19-9/总胆红素比值（CTR）在BTCs患者中的预后意义。
对2013年至2018年期间在北京协和医院被诊断为BTCs并接受手术切除的患者进行回顾性分析。收集人口统计学和临床参数。根据受试者工作特征（ROC）分析，将术前CA19-9和CTR分类为升高（>58.6和>0.83）。使用Student's -检验、卡方检验或Fisher精确检验对各组之间的人口统计学和临床参数进行比较。采用Kaplan-Meier方法进行生存分析，并通过对数秩检验评估变量与生存之间的关系。进行Cox回归分析以确定总生存的潜在危险因素。
共有109名参与者纳入最终分析。5年总生存率为18.0%，中位生存时间为1.58年。Kaplan-Meier分析表明，较高的CTR与较短的总生存期相关（15对50，<0.01）。单因素生存分析确定TNM分期、CA19-9和CTR为具有统计学意义的预后因素。在多因素Cox分析中，只有CTR被证明是一个显著的独立预后因素。
CTR是胆道癌患者的独立预后预测指标。
