Postoperative serum CEA and CA125 levels are supplementary to perioperative CA19-9 levels in predicting operative outcomes of pancreatic ductal adenocarcinoma
Postoperative serum CEA and CA125 levels are supplementary to perioperative CA19-9 levels in predicting operative outcomes of pancreatic ductal adenocarcinoma
复制标题
术后血清 CEA 和 CA125 水平可作为围手术期 CA19-9 水平的补充，用于预测胰腺导管腺癌的手术结果
DOI：
10.1016/j.surg.2016.08.005
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发表时间：
2017-02-01
期刊：
影响因子：
3.8
通讯作者：
Yu, Xian-Jun
中科院分区：
文献类型：
--
作者：
Xu, Hua-Xiang;Liu, Liang;Yu, Xian-Jun
背景糖类抗原（CA 19 -9）是胰腺癌切除术后监测疾病状态的公认标志物。然而，很少有报道血清标志物可提高术后CA 19 -9的预后能力，尤其是在术后CA 19 - 9正常的患者中。回顾性分析了353例经根治性切除术治疗的胰腺导管腺癌患者，并对包括142例可切除胰头癌患者的前瞻性队列进行了分析，作为验证队列。检测围术期血清CA 19 -9及术后血清CEA、CA 242、CA 72 -4、CA 50、CA 125、CA 153、AFP。术后CA 19 -9恢复正常的患者生存时间延长（无复发生存期：11.9个月;总生存期：22.5个月）与术后CA 19 -9降低但仍升高的患者相比（无复发生存期：6.8个月，P <0.001;总生存期：13.5个月，P <0.001）或术后CA 19 -9升高的患者（无复发生存期：3.5个月，P <0.001;总生存期：7.9个月，P <0.001），这与围手术期CA 19 -9持续正常的患者相似（无复发生存期：10.6个月，P <0.001）。799;总生存期：24.1个月，P = . 756）。无论术前CA 19 -9水平如何，术后CA 19 -9水平正常是术后积极结局的独立指标。术后CEA和CA 125升高是术后CA 19 -9正常患者的独立危险因素，而术后CA 125升高和术后CA 19 -9未降低是术后CA 19 - 9升高患者的独立预后指标。术后监测CEA和CA 125对胰腺癌术后CA 19 -9测定有预后意义。
Background. Carbohydrate antigen (CA19-9) is a well-established marker to monitor disease status after resection of pancreatic cancer. However, few serum markers have been reported to improve the prognostic ability of postoperative CA19-9, especially in patients with normal postoperative CA19-9.Methods. A total of 353 patients with pancreatic ductal adenocarcinoma treated by radical resection were reviewed retrospectively, and a prospective cohort including 142 patients with resectable pancreatic head carcinoma was analyzed as a validation cohort. Perioperative CA19-9 and postoperative serum markers (CEA, CA242, CA72-4, CA50, CA125, CA153, and AFP) were investigated.Results. Patients with postoperative normalization of CA19-9 had improved survival times (recurrence free survival: 11.9 months; overall survival: 22.5 months) compared with those with decreased but still elevated postoperative CA19-9 (recurrence-free survival: 6.8 months, P < .001; overall survival: 13.5 months, P < .001) or those with increased postoperative CA19-9 (recurrence-free survival: 3.5 months, P < .001; overall survival: 7.9 months, P < .001), which was similar to those with consistently normal CA19-9 during perioperative periods (recurrence-free survival: 10.6 months, P = . 799; overall survival: 24.1 months, P = . 756). Normal postoperative CA19-9 levels were an independent indicator for a positive outcome after operation, regardless of preoperative CA19-9 levels. Elevated postoperative CEA and CA125 were identified further as independent risk factors for patients with normal postoperative CA19-9, while elevated postoperative CA125 and nondecreased postoperative CA19-9 were independent prognostic markers for patients with elevated postoperative CA19-9.Conclusion. The postoperative monitoring of CEA and CA125 provided prognostic significance to the measurement of CA19-9 in pancreatic cancer after resection.