The use of adjusted preoperative CA 19-9 to predict the recurrence of resectable pancreatic cancer
The use of adjusted preoperative CA 19-9 to predict the recurrence of resectable pancreatic cancer
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DOI：
10.1016/j.jss.2006.10.007
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发表时间：
2007-06-01
影响因子：
2.2
通讯作者：
Kim, Byong Ro
中科院分区：
文献类型：
--
作者：
Kang, Chang Moo;Kim, Jun Young;Kim, Byong Ro
背景。尽管 CA 19-9 在胰腺癌的诊断和预后中有用，但胆汁淤积可能会错误地升高 CA 19-9 水平，这限制了胆道梗阻患者的临床实用性。本研究旨在评估调整后的术前 CA 19-9 水平在预测胰腺癌预后中的有用性。方法。回顾性分析了韩国首尔延世医疗中心 1990 年 1 月至 2005 年 6 月期间切除胰腺癌的患者的现有医疗记录。在胆红素为2mg/dL的情况下，通过将血清CA 19-9水平除以血清胆红素值来获得调整后的CA 19-9值。根据调整后的术前CA 19-9值评估无病生存率。结果。对六十一名患者进行了调查。他们调整后的术前 CA 19-9 值与实际基线 CA 19-9 值显着不同（129.4 +/- 225.2 U/mL，对比 442.1 +/- 645.5 U/mL，P < 0.0001）。单变量分析显示，胰周镜下侵犯（P = 0.0142）、淋巴血管侵犯（P = 0.0038）和调整后的术前 CA 19-9 >= 50 U/mL（P = 0.0049）是根治性切除后癌症复发的预测因素。调整后的术前 CA 19-9 >= 50 U/mL（Exp，(B) = 2.097，P = 0.027）是多变量分析中的独立预测因素。结论。调整后的术前CA 19-9值可以预测胰腺癌根治性切除术后复发的风险。根据血清胆红素值调整术前 CA 19-9 值来解释胰腺癌预后似乎更合理。 (D) 2007 Elsevier Inc. 保留所有权利。
Background. Despite the usefulness of CA 19-9 in the diagnosis and prognosis of pancreatic cancer, cholestasis can falsely elevate CA 19-9 levels, which contributes to limited clinical utility in patients with biliary obstruction. This study was designed to evaluate the usefulness of adjusted preoperative CA 19-9 levels in predicting a prognosis of pancreatic cancer.Methods. The available medical records of patients with resected pancreatic cancer from January 1990 to June 2005 were retrospectively viewed at Yonsei Medical Center, Seoul, Korea. The adjusted CA 19-9 value was obtained by dividing the serum CA 19-9 level by the values of serum bilirubin in case of bilirubin 2 mg/dL. Disease-free survival was evaluated according to the adjusted preoperative CA 19-9 value.Results. Sixty-one patients were investigated. Their adjusted preoperative CA 19-9 values were significantly different from the actual baseline CA 19-9 value (129.4 +/- 225.2 U/mL, versus 442.1 +/- 645.5 U/mL, P < 0.0001). On univariate analysis, peripancreatic microscopic invasion (P = 0.0142), lymphovascular invasion (P = 0.0038), and adjusted preoperative CA 19-9 >= 50 U/mL (P = 0.0049) were predictive factors for cancer recurrence after curative resection. Adjusted preoperative CA 19-9 >= 50 U/mL (Exp, (B) = 2.097, P = 0.027) was an independent predictive factor in multivariate analysis.Conclusions. The adjusted preoperative CA 19-9 value can predict the risk of recurrence after curative resection of pancreatic cancer. Interpreting the preoperative CA 19-9 value adjusted to the serum biliru- bin values seems to be more reasonable in evaluating prognosis of pancreatic cancer. (D) 2007 Elsevier Inc. All rights reserved.