Prognostic Value of the Preoperative Tumor Marker Index in Resected Pancreatic Ductal Adenocarcinoma: A Retrospective Single-Institution Study
Prognostic Value of the Preoperative Tumor Marker Index in Resected Pancreatic Ductal Adenocarcinoma: A Retrospective Single-Institution Study
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DOI：
10.1245/s10434-020-09022-3
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发表时间：
2020-08-17
影响因子：
3.7
通讯作者：
Baba, Hideo
中科院分区：
文献类型：
--
作者：
Miyata, Tatsunori;Hayashi, Hiromitsu;Baba, Hideo
背景预测预后可以为胰腺导管腺癌(PDAC)患者提供最合适的治疗策略。本研究旨在评价术前肿瘤标记物指数(Pre-TI)在预测PDAC切除术后预后中的临床价值。方法对183例胰腺癌切除患者的血清糖链抗原19-9(CA19-9)、癌胚抗原(CEA)、胰腺癌相关抗原-2(DUPAN-2)、S胰腺抗原-1(SPAN-1)进行回顾性分析，以阳性数作为前TI。结果高Pre-TI值(P>；=2)与肿瘤和淋巴结转移显著相关，Pre-TI值高的患者在无复发生存期(RF)(P<；0.0001)和总生存期(OS)(P<；0.0001)方面的预后均较低Pre-TI值低的患者差。前TI是RFS和OS预后不良的独立因素之一(风险比分别为2.36和0.0001，HR分别为2.27和0.0001)。此外，即使在调整后CA19-9值正常的患者(n=74，40.4%)中，Pre-TI高的患者的预后也明显差于Pre-Ti低的患者(rFS：P=0.002，LOG-RANK；OS：P=0.031，LOG-RANK)。结论前TI可作为预测PDAC切除患者预后的有效指标。具有高前TI的患者可能需要额外的策略来改善他们的预后。
Background The prediction of prognostic outcomes can provide the most suitable strategy for patients with pancreatic ductal adenocarcinoma (PDAC). This study aimed to evaluate the clinical value of the preoperative tumor marker index (pre-TI) in predicting prognostic outcomes after resection for PDAC. Methods For 183 patients who underwent pancreatic resection of PDAC, adjusted carbohydrate antigen 19-9 (CA19-9), carcinoembryonic antigen (CEA), pancreatic cancer-associated antigen-2 (DUpan-2), and s-pancreas-1 antigen (SPan-1) were retrospectively evaluated, and the positive number of these markers was scored as the pre-TI. Results A high pre-TI (>= 2) was significantly associated with a larger tumor and lymph node metastases, and the patients with a high pre-TI had worse prognostic outcomes in terms of both relapse-free survival (RFS) (P < 0.0001, log-rank) and overall survival (OS) (P < 0.0001, ?log-rank) than the patients with a low pre-TI. The pre-TI was one of the independent factors of a poor prognosis for RFS (hazard ratio [HR], 2.36;P < 0.0001) and OS (HR, 2.27;P < 0.0001). In addition, even for the patients with normal adjusted CA19-9 values (n = 74, 40.4%), those with the high pre-TI had a significantly poorer prognosis than those with a low pre-TI (RFS:P = 0.002, log-rank; OS:P = 0.031, log-rank). Conclusions The pre-TI could be a potent predictive marker of prognostic outcomes for patients with resections for PDAC. Patients with a high pre-TI may need additional strategies to improve their prognosis.