Law Jade, Trieu Harry, Kaleka Guneet, Turkiewicz Joanna, Palmer Samantha, Lee Jennifer M, Chen Kathryn T, Tabibian James H
LAC-USC Hematology and Oncology Fellowship Program, Los Angeles, CA 90033, USA.
LAC-USC Internal Medicine Residency Program, Los Angeles, CA 90033, USA.
Cancers (Basel). 2023 Mar 11;15(6):1723. doi: 10.3390/cancers15061723.
Although CA 19-9 is a commonly used tumor marker in the management of PBMs, the literature describing outcomes in patients with PBMs who have undetectable or low (hereinafter "low") CA 19-9 levels remains scarce. In this study, we sought to compare clinical features and outcomes in patients with PBMs and low CA 19-9 levels to those with normal and elevated CA 19-9 levels.
We retrospectively collected data on patients with biopsy-confirmed PBMs and stratified patients into categories based on their CA 19-9 level at diagnosis. Survival curves were estimated for patients in each of the three aforementioned CA 19-9 groups using the Kaplan-Meier method and compared using a Cox proportional hazards regression model.
Of the 283 patients identified, 23 (8.1%) had low, 70 (24.7%) had normal, and 190 (67.1%) had elevated CA 19-9 levels. After controlling for sex, age, BMI, the presence of metastases at the time of diagnosis, and treatment with curative intent, the hazard ratio for death in the elevated CA 19-9 group compared to the low CA 19-9 group was 1.993 (95% CI 1.089-3.648; = 0.025).
The elevated CA 19-9 level compared to the low CA 19-9 level and the presence of metastases were associated with an increased hazard of death, while treatment with curative intent was associated with a decreased hazard of death.
尽管CA 19-9是胰腺导管内乳头状黏液性肿瘤（PBM）管理中常用的肿瘤标志物，但关于CA 19-9水平检测不到或低（以下简称“低”）的PBM患者结局的文献仍然很少。在本研究中，我们试图比较CA 19-9水平低的PBM患者与CA 19-9水平正常和升高的患者的临床特征和结局。
我们回顾性收集了经活检确诊为PBM的患者的数据，并根据诊断时的CA 19-9水平将患者分层。使用Kaplan-Meier方法估计上述三个CA 19-9组中每组患者的生存曲线，并使用Cox比例风险回归模型进行比较。
在确定的283例患者中，23例（8.1%）CA 19-9水平低，70例（24.7%）CA 19-9水平正常，190例（67.1%）CA 19-9水平升高。在控制了性别、年龄、体重指数、诊断时转移灶的存在以及根治性治疗后，CA 19-9水平升高组与CA 19-9水平低组相比的死亡风险比为1.993（95%可信区间1.089-3.648；P = 0.025）。
与CA 19-9水平低相比，CA 19-9水平升高以及转移灶的存在与死亡风险增加相关，而根治性治疗与死亡风险降低相关。
