Elevation of CA19-9 and CEA is associated with a poor prognosis in patients with resectable gallbladder carcinoma

Elevation of CA19-9 and CEA is associated with a poor prognosis in patients with resectable gallbladder carcinoma
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DOI：
10.1016/j.hpb.2017.06.011
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发表时间：
2017-11-01
期刊：
HPB
影响因子：
2.9
通讯作者：
Zhang, Baohua
Zhang, Baohua
中科院分区：
医学3区
文献类型：
--
作者：
Wen, Zhijian;Si, Anfeng;Zhang, Baohua

文献摘要

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目的：探讨肿瘤标志物癌胚抗原(CEA)和糖类抗原19-9(CA19-9)联合检测是否有助于预测胆囊癌(GBC)术后患者的预后。方法：回顾分析2003年1月至2013年12月收治的390例GBC患者的临床病理特征和生存期。采用时间依赖的受者操作特征(ROC)评价肿瘤标志物的预后能力。结果：CEA和CA19-9联合检测预后最好，中位生存期为27个月，R0率为86%。两种肿瘤标志物均升高的患者预后最差，R0率较低(p&lt；0.001)。CEA和CA19-9的联合检测是影响患者总体生存的独立危险因素。CEA和CA19-9联合应用5年后AUROC为0.798，与CEA(0.765)或CA19-9(0.771)相似(p=0.103，p=0.147)。结论：CEA和CA19-9联合应用与胆囊癌切除术后预后不良有关。
Aims: The aim of this study was to determine whether a combination of the tumour markers carcinoembryonic (CEA) and carbohydrate antigen 19-9 (CA19-9) would be helpful in predicting the prognosis of patients with gallbladder carcinoma (GBC) who underwent resection.Methods: A retrospective analysis of clinico-pathological features and survival of 390 patients with GBC who were treated between January 2003 and December 2013. Time-dependent receiver operating characteristic (ROC) was used to evaluate the prognostic ability of tumour markers. Combinations of preoperative CEA and CA19-9 were tested as potential prognostic factors.Results: The evaluation of preoperative CEA and CA19-9 showed that patients with both tumour markers within the normal range had the best prognosis with a median survival of 27 months and R0 rate of 86%. Patients with both tumour markers elevated had the poorest prognosis and lower R0 rate (p < 0.001). The combination of CEA and CA19-9 was an independent risk factor for overall survival. The AUROC at 5 years of combination of CEA and CA19-9 was 0.798, which was similar to CEA (0.765) or CA19-9 (0.771) alone (p = 0.103, p = 0.147).Conclusions: A combination of an elevated preoperative CEA and CA19-9 was associated with a worse prognosis for patients with GBC who underwent resection.