Xia Dong-Qin, Zhou Yong, Yang Shuang, Li Fang-Fei, Tian Li-Ya, Li Yan-Hua, Xu Hai-Yan, Xiao Cai-Zhi, Wang Wei
Oncology Treatment Center of Traditional Chinese Medicine, Chongqing University Cancer Hospital, Chongqing 400030, China.
Department of Oncology, Chongqing Weisiteng Biotech Translational Research Institute, Chongqing 430039, China.
World J Gastrointest Oncol. 2024 Mar 15;16(3):798-809. doi: 10.4251/wjgo.v16.i3.798.
Pancreatic ductal adenocarcinoma (PDAC) is a common cancer with increasing morbidity and mortality due to changes of social environment.
To evaluate the significance of serum carbohydrate antigen 19-9 (CA19-9) and tumor size changes pre- and post-neoadjuvant therapy (NAT).
This retrospective study was conducted at the Chongqing Key Laboratory of Translational Research for Cancer Metastasis and Individualized Treatment, Chongqing University Cancer Hospital. This study specifically assessed CA19-9 levels and tumor size before and after NAT.
A total of 156 patients who completed NAT and subsequently underwent tumor resection were included in this study. The average age was 65.4 ± 10.6 years and 72 (46.2%) patients were female. Before survival analysis, we defined the post-NAT serum CA19-9 level/pre-NAT serum CA19-9 level as the CA19-9 ratio (CR). The patients were divided into three groups: CR < 0.5, CR > 0.5 and < 1 and CR > 1. With regard to tumor size measured by both computed tomography and magnetic resonance imaging, we defined the post-NAT tumor size/pre-NAT tumor size as the tumor size ratio (TR). The patients were then divided into three groups: TR < 0.5, TR > 0.5 and < 1 and TR > 1. Based on these groups divided according to CR and TR, we performed both overall survival (OS) and disease-free survival (DFS) analyses. Log-rank tests showed that both OS and DFS were significantly different among the groups according to CR and TR ( < 0.05). CR and TR after NAT were associated with increased odds of achieving a complete or near-complete pathologic response. Moreover, CR (hazard ratio: 1.721, 95%CI: 1.373-3.762; = 0.006), and TR (hazard ratio: 1.435, 95%CI: 1.275-4.363; = 0.014) were identified as independent factors associated with OS.
This study demonstrated that post-NAT serum CA19-9 level/pre-NAT serum CA19-9 level and post-NAT tumor size/pre-NAT tumor size were independent factors associated with OS in patients with PDAC who received NAT and subsequent surgical resection.
胰腺导管腺癌（PDAC）是一种常见癌症，由于社会环境变化，其发病率和死亡率不断上升。
评估新辅助治疗（NAT）前后血清糖类抗原19-9（CA19-9）及肿瘤大小变化的意义。
本回顾性研究在重庆大学附属肿瘤医院肿瘤转移与个体化治疗转化研究重庆市重点实验室开展。本研究专门评估了NAT前后的CA19-9水平及肿瘤大小。
本研究共纳入156例完成NAT并随后接受肿瘤切除术的患者。平均年龄为65.4±10.6岁，72例（46.2%）为女性。在生存分析前，我们将NAT后血清CA19-9水平/NAT前血清CA19-9水平定义为CA19-9比值（CR）。患者被分为三组：CR<0.5、CR>0.5且<1以及CR>1。关于通过计算机断层扫描和磁共振成像测量的肿瘤大小，我们将NAT后肿瘤大小/NAT前肿瘤大小定义为肿瘤大小比值（TR）。然后患者被分为三组：TR<0.5、TR>0.5且<1以及TR>1。基于根据CR和TR划分的这些组，我们进行了总生存期（OS）和无病生存期（DFS）分析。对数秩检验显示，根据CR和TR分组，OS和DFS在各组之间均存在显著差异（<0.05）。NAT后的CR和TR与实现完全或接近完全病理缓解的几率增加相关。此外，CR（风险比：1.721，95%置信区间：1.373 - 3.762；=0.006）和TR（风险比：1.435，95%置信区间：1.275 - 4.363；=0.014）被确定为与OS相关的独立因素。
本研究表明，在接受NAT及后续手术切除的PDAC患者中，NAT后血清CA19-9水平/NAT前血清CA19-9水平以及NAT后肿瘤大小/NAT前肿瘤大小是与OS相关的独立因素。
