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ASO作者反思：癌胚抗原作为新辅助治疗的临界可切除胰腺癌患者无法进行手术的预测指标

ASO Author Reflections: Carcinoembryonic Antigen as a Predictor of Failure to Reach Surgery in Patients with Borderline Resectable Pancreatic Cancer Undergoing Neoadjuvant Therapy.

作者信息

Jacover Arielle, Pencovich Niv

机构信息

Department of General Surgery and Transplantation, Sheba Medical Center, Tel-Hashomer, Faculty of Medicine and Health Sciences, Tel-Aviv University, Tel-Aviv, Israel.

出版信息

Ann Surg Oncol. 2025 May 28. doi: 10.1245/s10434-025-17536-x.

DOI:10.1245/s10434-025-17536-x
PMID:40437339
Abstract

Borderline resectable pancreatic ductal adenocarcinoma (BR-PDAC) presents a therapeutic challenge, balancing the benefits of neoadjuvant therapy (NT) against the risk of missing the opportunity for cure by upfront surgery. In this retrospective study, we evaluated real-world outcomes in patients with BR-PDAC undergoing NT and identified elevated baseline carcinoembryonic antigen (CEA) as an independent predictor of failure to reach surgery, primarily due to local tumor progression. Our findings suggest that CEA may serve as a practical biomarker to guide treatment selection between NT and upfront surgery.

摘要

可切除边缘的胰腺导管腺癌（BR-PDAC）带来了治疗挑战，需要在新辅助治疗（NT）的益处与因直接手术而错过治愈机会的风险之间进行权衡。在这项回顾性研究中，我们评估了接受NT的BR-PDAC患者的实际治疗结果，并确定基线癌胚抗原（CEA）升高是无法进行手术的独立预测因素，主要原因是局部肿瘤进展。我们的研究结果表明，CEA可作为一种实用的生物标志物，以指导NT和直接手术之间的治疗选择。

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本文引用的文献

1
Elevated Carcinoembryonic Antigen Levels Predict Failure to Reach Surgery in Patients with Borderline Resectable Pancreatic Cancer Referred to Neoadjuvant Therapy.癌胚抗原水平升高预示着接受新辅助治疗的临界可切除胰腺癌患者无法进行手术。
Ann Surg Oncol. 2025 May 13. doi: 10.1245/s10434-025-17433-3.
2
Serum CEA as a Prognostic Marker for Overall Survival in Patients with Localized Pancreatic Adenocarcinoma and Non-Elevated CA19-9 Levels Treated with FOLFIRINOX as Initial Treatment: A TAPS Consortium Study.血清 CEA 作为 FOLFIRINOX 初始治疗的局部胰腺腺癌和非升高 CA19-9 水平患者总生存的预后标志物：TAPS 联盟研究。
Ann Surg Oncol. 2024 Mar;31(3):1919-1932. doi: 10.1245/s10434-023-14680-0. Epub 2024 Jan 3.
3
Preoperative chemotherapy, radiotherapy and surgical decision-making in patients with borderline resectable and locally advanced pancreatic cancer.
局部进展期和交界可切除胰腺癌患者的术前化疗、放疗和手术决策。
Nat Rev Gastroenterol Hepatol. 2024 Feb;21(2):101-124. doi: 10.1038/s41575-023-00856-2. Epub 2023 Nov 30.
4
Role of Serum Carcinoma Embryonic Antigen (CEA) Level in Localized Pancreatic Adenocarcinoma: CEA Level Before Operation is a Significant Prognostic Indicator in Patients With Locally Advanced Pancreatic Cancer Treated With Neoadjuvant Therapy Followed by Surgical Resection: A Retrospective Analysis.血清癌胚抗原（CEA）水平在局限性胰腺腺癌中的作用：术前 CEA 水平是新辅助治疗后接受手术切除的局部晚期胰腺癌患者的重要预后指标：回顾性分析。
Ann Surg. 2022 May 1;275(5):e698-e707. doi: 10.1097/SLA.0000000000004148. Epub 2020 Jul 24.
5
Diagnostic and prognostic value of carcinoembryonic antigen in pancreatic cancer: a systematic review and meta-analysis.癌胚抗原在胰腺癌中的诊断和预后价值：一项系统评价和荟萃分析
Onco Targets Ther. 2017 Sep 15;10:4591-4598. doi: 10.2147/OTT.S145708. eCollection 2017.