Fan Shanshan, Zhao Kexin, Lei Jiabao, Ge Yang
Department of Oncology, Beijing Chaoyang Hospital, Capital Medical University, Beijing, 100020, China.
The Third Clinical School of Medicine, Capital Medical University, Beijing, China.
Discov Oncol. 2025 May 8;16(1):696. doi: 10.1007/s12672-025-02527-x.
Biliary tract cancers (BTCs) are highly invasive malignancies with poor prognoses. However, reliable biomarkers for survival prediction remain lacking. Notably, abnormal lipid metabolism has elicited increasing interest in digestive tract tumors, with the liver playing an important role in lipid metabolism.
To explore the relationship between hepatic lipid metabolism-related indicators, assessed through routine clinical biochemical testing and survival prognosis in patients with BTCs.
Overall, 109 patients with a pathological diagnosis of BTC from 2017 to 2023 were included in this study. Univariate and multivariate Cox regression analyses were performed using R Studio software, and survival curves were plotted.
Univariate analysis revealed that tumor location and preoperative total bile acid (TBA), carcinoembryonic antigen, cancer antigen (CA)125, and CA19-9 levels were correlated with patient survival (P < 0.05). Multivariate Cox regression analysis identified increased TBA level [hazard ratio (HR) = 0.445, P = 0.004] as an independent prognostic factor for longer survival. Conversely, tumor location [intrahepatic cholangiocarcinoma (iCCA) and/or extrahepatic cholangiocarcinoma (eCCA)] (HR = 2.463, P = 0.036) and increased CA125 and CA19-9 levels (HR = 2.549, P = 0.008 and HR = 2.100, P = 0.019) were independent prognostic factors for shorter survival. Additionally, Kaplan‒Meier survival curves revealed significantly longer survival in patients with increased TBA levels than those in the normal group (P = 0.012). Conversely, patients with iCCA and/or eCCA tumor location and increased CA125 and CA19-9 levels had significantly shorter median survival (P = 0.044, P = 0.013, and P = 0.012, respectively).
TBA may be a biomarker for predicting survival in patients with operable BTC, highlighting its clinical significance and application potential.
胆道癌（BTC）是具有高度侵袭性的恶性肿瘤，预后较差。然而，仍缺乏用于生存预测的可靠生物标志物。值得注意的是，脂质代谢异常在消化道肿瘤中引起了越来越多的关注，肝脏在脂质代谢中起着重要作用。
通过常规临床生化检测评估肝脏脂质代谢相关指标与BTC患者生存预后之间的关系。
本研究共纳入2017年至2023年期间109例经病理诊断为BTC的患者。使用R Studio软件进行单因素和多因素Cox回归分析，并绘制生存曲线。
单因素分析显示，肿瘤位置以及术前总胆汁酸（TBA）、癌胚抗原、癌抗原（CA）125和CA19-9水平与患者生存相关（P<0.05）。多因素Cox回归分析确定TBA水平升高[风险比（HR）=0.445，P=0.004]是生存期延长的独立预后因素。相反，肿瘤位置[肝内胆管癌（iCCA）和/或肝外胆管癌（eCCA）]（HR=2.463，P=0.036）以及CA125和CA19-9水平升高（HR=2.549，P=0.008和HR=2.100，P=0.019）是生存期缩短的独立预后因素。此外，Kaplan-Meier生存曲线显示，TBA水平升高的患者生存期明显长于正常组（P=0.012）。相反，iCCA和/或eCCA肿瘤位置以及CA125和CA19-9水平升高的患者中位生存期明显缩短（分别为P=0.044、P=0.013和P=0.012）。
TBA可能是可手术切除的BTC患者生存预测的生物标志物，突出了其临床意义和应用潜力。
