Importance of Normalization of Carbohydrate Antigen 19-9 in Patients With Intrahepatic Cholangiocarcinoma.
Importance of Normalization of Carbohydrate Antigen 19-9 in Patients With Intrahepatic Cholangiocarcinoma.
复制标题
碳水化合物抗原 19-9 正常化对肝内胆管癌患者的重要性
DOI：
10.3389/fonc.2021.780455
复制
发表时间：
2021
影响因子：
4.7
通讯作者：
Li D
中科院分区：
文献类型：
--
作者：
Li H;Feng Y;Liu C;Li J;Li J;Wu H;Wang G;Li D
背景尽管糖链抗原19-9（CA 19 -9）是肝内胆管癌（ICC）患者的既定预后标志物，但术前CA 19 -9升高并在切除术后恢复正常的意义尚不清楚。本研究旨在探讨术前升高的CA 19 -9在根治性切除术后恢复正常是否对ICC患者的预后有影响。方法确定2009年至2018年期间接受I至III期ICC根治性切除术的患者。将患者分为三个队列：术前CA 19 -9正常、术前CA 19 -9升高但术后CA 19 -9正常、术后CA 19 -9持续升高。分析总生存期（OS）、无复发生存期（RFS）和随时间变化的风险函数曲线。结果共纳入511例患者（247例[48.3%]男性;中位年龄58岁）。术前CA 19 -9升高的患者（n = 378）与术前CA 19 -9正常的患者（n = 152）相比，RFS和OS更差（均p < 0.001）。术后CA 19 -9持续升高的患者（n = 254）与术后CA 19 -9正常的联合队列（n = 257）相比，RFS和OS较低（均p < 0.001）。风险函数曲线显示，术后CA 19 -9升高组的复发风险和死亡风险达到峰值的时间早于其他2组，且高于其他2组。多变量分析表明，术后CA 19 -9持续升高而非正常化是ICC患者RFS和OS缩短的独立风险因素。结论术前血清CA 19 -9水平升高，经根治性切除后恢复正常，并不是ICC预后不良的指标。术后CA 19 -9持续升高的患者复发和死亡的风险增加。
Background Although carbohydrate antigen 19-9 (CA19-9) is an established prognostic marker for intrahepatic cholangiocarcinoma (ICC) patients, the significance of elevated preoperative CA19-9 that normalized after resection remains unknown. This study aimed to investigate whether elevated preoperative CA19-9 that normalized after curative resection had an impact on prognosis among patients with ICC. Methods Patients who underwent curative resection for stage I to III ICC between 2009 and 2018 were identified. Patients were categorized into three cohorts: normal preoperative CA19-9, elevated preoperative CA19-9 but normalized postoperative CA19-9, and persistently elevated postoperative CA19-9. Overall survival (OS), recurrence-free survival (RFS), and hazard function curves over time were analyzed. Results A total of 511 patients (247 [48.3%] male; median age, 58 years) were included. Patients with elevated preoperative CA19-9 (n = 378) were associated with worse RFS and OS than those with normal preoperative CA19-9 (n = 152) (both p < 0.001). Patients with persistently elevated postoperative CA19-9 (n = 254) were correlated with lower RFS and OS than the combined cohorts with normal postoperative CA19-9 (n = 257) (both p < 0.001). The hazard function curves revealed that the risk of recurrence and mortality peaked earlier and higher in the elevated postoperative CA19-9 group than the other 2 groups. Multivariate analyses identified persistently elevated, rather than normalized, postoperative CA19-9 as an independent risk factor for shorter RFS and OS in ICC. Conclusions Elevated preoperative serum CA19-9 that normalizes after curative resection is not an indicator of poor prognosis in ICC. Patients with persistently elevated postoperative CA19-9 are at increased risk of recurrence and death.
登录
查看更多内容
影响因子：
3.7
作者：
Moro, Amika;Mehta, Rittal;Pawlik, Timothy M.
通讯作者：
Pawlik, Timothy M.
术前D-二聚体和CA19-9联合预测肝内胆管癌患者根治性切除术后的淋巴结转移和生存
影响因子：
--
作者：
Chen, Qichen;Zheng, Yiling;Wu, Jianxiong
通讯作者：
Wu, Jianxiong
影响因子：
45.3
作者：
Edeline, Julien;Benabdelghani, Meher;Phelip, Jean-Marc
通讯作者：
Phelip, Jean-Marc
影响因子：
9
作者：
Tsai, Susan;George, Ben;Evans, Douglas B.
通讯作者：
Evans, Douglas B.
影响因子：
--
作者：
Yoo T;Park SJ;Han SS;Kim SH;Lee SD;Kim YK;Kim TH;Woo SM;Lee WJ;Hong EK
通讯作者：
Hong EK