Preoperative serum CA125 levels predict the prognosis in hyperbilirubinemia patients with resectable pancreatic ductal adenocarcinoma.
Preoperative serum CA125 levels predict the prognosis in hyperbilirubinemia patients with resectable pancreatic ductal adenocarcinoma.
复制标题
术前血清 CA125 水平可预测可切除胰管腺癌高胆红素血症患者的预后
DOI：
10.1097/md.0000000000000751
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发表时间：
2015-05
期刊：
影响因子：
1.6
通讯作者：
Yu XJ
中科院分区：
文献类型：
--
作者：
Chen T;Zhang MG;Xu HX;Wang WQ;Liu L;Yu XJ
血清糖链抗原19-9（CA 19 -9）是胰腺导管腺癌（PDAC）预后的重要指标。然而，高胆红素血症和CA 19 -9非分泌表型限制了单独使用血清CA 19 -9。为探讨术前血清CA 125水平对PDAC患者预后的影响，对211例PDAC患者进行回顾性研究，根据血清胆红素水平分为2组。通过单因素和多因素分析评估所有临床病理因素的预后意义，并比较每个因素在预测总生存期（OS）和无复发生存期（RFS）中的表现，术前高CA 125、高TNM分期和淋巴结转移是所有患者和2个亚组中OS和RFS的独立风险预测因子。但高CA 19 -9仅在考虑所有患者和未升高胆红素的患者时才有意义。采用时间依赖的受试者操作特征分析，血清CA 19 -9对OS和RFS的预测性能优于血清CA 125，血清CA 125高可独立预测预后不良。重要的是，在PDAC合并高胆红素血症的患者中，术前血清CA 125可以预测预后，而CA 19 -9不能。术前CA 19 -9对生存率的预测性能优于CA 125，并且在所有患者和未升高胆红素的患者中，CA 19 -9的性能并未下降，但受高胆红素血症的显著影响。
AbstractSerum carbohydrate antigen 19-9 (CA19-9) is widely used to predict the prognosis for pancreatic ductal adenocarcinoma (PDAC). However, hyperbilirubinemia and the CA19-9 nonsecretor phenotype restrict the usage of serum CA19-9 alone. The goal of this study was to confirm the prognostic role of preoperative serum CA125 in PDAC, especially in patients with jaundice.A total of 211 patients with resected PDAC were eligible for this retrospective study, and were classified into 2 groups based on serum bilirubin levels. The prognostic significance of all clinicopathologic factors was evaluated by univariate and multivariate analyses, and the performance of each factor in predicting overall survival (OS) and recurrence-free survival (RFS) was compared.High preoperative CA125, high TNM stage, and lymph node metastasis were independent risk predictors for OS and RFS in all patients and the 2 subgroups, but high CA19-9 was only significant when considering all patients and those with nonelevated bilirubin. Using time-dependent receiver-operating characteristic analysis, better predictive performance for OS and RFS was observed for serum CA19-9 as compared to serum CA125 in these patients.High serum CA125 can independently predict poor prognosis. Importantly, in PDAC patients with hyperbilirubinemia, preoperative serum CA125 can predict the prognosis, whereas CA19-9 cannot. Preoperative CA19-9 had better predictive performance for survival than CA125, and the performance of CA19-9 did not decline between all patients and those with nonelevated bilirubin, but was significantly affected by hyperbilirubinemia.