Tumor Marker Kinetics as Prognosticators in Patients with Unresectable Gallbladder Adenocarcinoma Undergoing Palliative Chemotherapy.
Tumor Marker Kinetics as Prognosticators in Patients with Unresectable Gallbladder Adenocarcinoma Undergoing Palliative Chemotherapy.
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DOI：
10.5009/gnl16588
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发表时间：
2018-01-15
期刊：
影响因子：
3.4
通讯作者：
Lee BS
中科院分区：
文献类型：
--
作者：
Lee JW;Kim YT;Lee SH;Son JH;Kang JW;Ryu JK;Jang DK;Paik WH;Lee BS
目的探讨癌胚抗原（CEA）和糖链抗原（CA）19-9在胆囊癌姑息化疗中的预后价值。纳入123例经病理证实不可切除的GBC患者。检测化疗前后血清CEA和CA 19-9水平的变化。采用受试者工作特征曲线分析、CEA、CA 19-9的Kaplan-Meier分析以及联合变化来评估最佳临界值和生存率。肿瘤标志物降低的患者的无进展生存期（PFS）和总生存期（OS）显著优于肿瘤标志物升高的患者。化疗前后CA 19-9比值预测3个月PFS和1年OS的曲线下面积最高。在多变量分析中，不可切除GBC患者姑息化疗期间血清CA 19-9升高是PFS和OS较差的独立预测因素，风险比为2.20（p=0.001）和1.67（p=0.020）。增加>10倍的患者被认为是疾病进展，而增加>3倍的个体可能从早期成像随访中受益。CA 19-9动力学是接受姑息化疗的不可切除GBC患者的PFS和OS的可靠指标。
To determine the prognostic value of carcinoembryonic antigen (CEA) and carbohydrate antigen (CA) 19-9 in gallbladder cancer (GBC) during palliative chemotherapy. One hundred and twenty-three patients with pathologically confirmed unresectable GBC were included. Differences in serum CEA and CA 19-9 levels before and after chemotherapy were measured. Receiver operating characteristic curve analysis, Kaplan-Meier analyses of CEA, CA 19-9, and combined changes were performed to assess the optimal cutoff values and survival rates. Patients with decreased tumor markers had significantly better progression-free survival (PFS) and overall survival (OS) than patients with increased tumor markers. The pre- and postchemotherapy CA 19-9 ratio had the highest area-under-the-curve values for predicting 3-month PFS and 1-year OS. In the multivariate analysis, increases in serum CA 19-9 during palliative chemotherapy in patients with unresectable GBC was an independent prognosticator of poor PFS and OS, with hazard ratios of 2.20 (p=0.001) and 1.67 (p=0.020), respectively. Patients with increases >10-fold were considered to have progressive disease, whereas individuals with increases >3-fold were likely to benefit from early imaging follow-up. CA 19-9 kinetics was a reliable prognosticator of PFS and OS in patients with unresectable GBC who underwent palliative chemotherapy.
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影响因子：
4.6
作者：
Park JO;Oh DY;Hsu C;Chen JS;Chen LT;Orlando M;Kim JS;Lim HY
通讯作者：
Lim HY
DOI：
10.1016/j.ijrobp.2012.11.020
发表时间：
2013-05-01
影响因子：
7
作者：
Vainshtein, Jeffrey M.;Schipper, Matthew;Zalupski, Mark M.;Lawrence, Theodore S.;Abrams, Ross;Francis, Isaac R.;Khan, Gazala;Leslie, William;Ben-Josef, Edgar
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DOI：
10.1007/s00432-012-1371-3
发表时间：
2013-04-01
影响因子：
3.6
作者：
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通讯作者：
Boeck, Stefan
影响因子：
3.2
作者：
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通讯作者：
Chen, Miin-Fu