术前血清肿瘤标志物 CEA、CA19-9、CA125 和 CA15-3 在脐尿管癌手术治疗中的临床价值。

Clinical value of preoperative serum tumor markers CEA, CA19-9, CA125, and CA15-3 in surgically treated urachal cancer.

机构信息

Department of Urology, The Netherlands Cancer Institute, Amsterdam, The Netherlands.

Department of Analytical Chemistry, The Netherlands Cancer Institute, Amsterdam, The Netherlands.

出版信息

Urol Oncol. 2023 Jul;41(7):326.e17-326.e24. doi: 10.1016/j.urolonc.2023.01.018. Epub 2023 Feb 21.

DOI:10.1016/j.urolonc.2023.01.018

PMID:36813613

Abstract

INTRODUCTION

Urachal adenocarcinoma (UrAC) is a very rare malignancy with a poor prognosis. The role of preoperative serum tumor markers (STMs) in UrAC is unknown. The aim of this study was to assess the clinical value of elevated STMs including carcinoembryonic antigen (CEA), cancer antigen 19-9 (CA19-9), cancer antigen 125 (CA125), and cancer antigen 15-3 (CA15-3) in surgically treated UrAC, and to evaluate their prognostic significance.

METHODS

This was a retrospective study of consecutive patients with histopathologically confirmed UrAC who underwent surgical treatment at a single tertiary hospital. Blood levels of CEA, CA19-9, CA125, and CA15-3 were determined before surgery. The proportion of patients with elevated STMs was calculated, as well as the association between elevated STMs and clinicopathological characteristics, recurrence-free survival and disease-specific survival.

RESULTS

Of the 50 patients included; CEA, CA 19-9, CA125, and CA15-3 were elevated in 40%, 25%, 26%, and 6% respectively. Elevated CEA was associated with higher pT-stage (odds ratio [OR] 3.3 [95% confidence interval 1.0-11.1], P = 0.003), higher Sheldon stage (OR 6.9 [95% CI 0.8-60.4], P = 0.01), male sex (OR 4.7 [95% CI 1.2-18.3], P = 0.01), and the presence of peritoneal metastases at the time of diagnosis (OR 3.5 [95% CI 0.9-14.2], P = 0.04). Elevated CA19-9 was associated with signet-cell component (OR 1.7 [95% CI 0.9-3.3], P = 0.03) and elevated CA125 was associated with peritoneal metastases at the time of diagnosis (OR 6.0 [95% CI 1.2-30.6], P = 0.04). Elevated STMs before surgery were not associated with recurrence-free survival and/or disease-specific survival.

CONCLUSION

A subset of patients with surgically treated UrAC has elevated STMs preoperatively. CEA was most frequently (40%) elevated and correlated with unfavorable tumor characteristics. However, STM levels did not correlate with prognostic outcomes.

摘要

简介

脐尿管腺癌（UrAC）是一种罕见的恶性肿瘤，预后不良。术前血清肿瘤标志物（STM）在 UrAC 中的作用尚不清楚。本研究旨在评估包括癌胚抗原（CEA）、癌抗原 19-9（CA19-9）、癌抗原 125（CA125）和癌抗原 15-3（CA15-3）在内的升高的 STM 在接受手术治疗的 UrAC 中的临床价值，并评估其预后意义。

方法

这是一项对在一家三级医院接受手术治疗的经组织病理学证实的 UrAC 连续患者进行的回顾性研究。在术前测定 CEA、CA19-9、CA125 和 CA15-3 的血液水平。计算升高 STM 的患者比例，以及升高 STM 与临床病理特征、无复发生存和疾病特异性生存之间的关系。

结果

在 50 例患者中，CEA、CA19-9、CA125 和 CA15-3 分别升高了 40%、25%、26%和 6%。升高的 CEA 与更高的 pT 分期（优势比 [OR] 3.3 [95%置信区间 1.0-11.1]，P=0.003）、更高的 Sheldon 分期（OR 6.9 [95%CI 0.8-60.4]，P=0.01）、男性（OR 4.7 [95%CI 1.2-18.3]，P=0.01）和诊断时腹膜转移（OR 3.5 [95%CI 0.9-14.2]，P=0.04）相关。升高的 CA19-9 与印戒细胞成分相关（OR 1.7 [95%CI 0.9-3.3]，P=0.03），而升高的 CA125 与诊断时腹膜转移相关（OR 6.0 [95%CI 1.2-30.6]，P=0.04）。术前升高的 STM 与无复发生存和/或疾病特异性生存无关。