Postoperative CA19-9 Change Is a Useful Predictor of Intrahepatic Cholangiocarcinoma Survival following Liver Resection.
Postoperative CA19-9 Change Is a Useful Predictor of Intrahepatic Cholangiocarcinoma Survival following Liver Resection.
复制标题
DOI：
10.1155/2015/298985
复制
发表时间：
2015
期刊：
影响因子：
--
通讯作者：
Hong EK
中科院分区：
文献类型：
--
作者：
Yoo T;Park SJ;Han SS;Kim SH;Lee SD;Kim YK;Kim TH;Woo SM;Lee WJ;Hong EK
背景探讨肝内胆管细胞癌（ICC）患者围手术期血清CA 19 -9水平变化对预测术后生存期的临床意义。方法.我们回顾性分析了2001年4月至2010年7月期间接受手术切除治疗的74例ICC患者的数据。分析围手术期CA 19 -9（术前水平、术后最低水平和复发时水平）水平的患者分布和生存率。结果术前，有45例患者的术前CA 19 -9水平较高（>37 U/mL），29例患者的术前CA 19 -9水平正常（≤37 U/mL）。在45例CA 19 -9水平高的患者中，34例在切除术后CA 19 -9水平恢复正常，11例持续高水平。在34例CA 19 -9水平正常的患者中，18例复发。术前水平正常的29例患者中，15例复发。多变量分析显示，（风险比[HR] = 3.881，p < 0.01），术后CA 19 -9水平持续升高（HR = 4.41，p < 0.001），神经周侵犯（HR = 3.073，p = 0.01）、切缘窄（HR = 3.152，p = 0.05）和淋巴结转移（HR = 3.427，p = 0.02）是生存的重要独立危险因素。结论.术后CA 19 -9水平正常的患者生存期较长。因此，术后正常化的CA 19 -9可能是ICC存活的有用临床标志物。
Background. To investigate the clinical significance of the perioperative CA19-9 change for predicting survival in intrahepatic cholangiocarcinoma (ICC) patients treated with surgical resection. Methods. We retrospectively reviewed the data from 74 ICC patients treated with surgical resection between April 2001 and July 2010. Perioperative CA19-9 (preoperative level, postoperative lowest level, and level at recurrence) levels were analyzed for patient distribution and survival. Results. Before surgery, there were 45 patients who had high preoperative CA19-9 levels (>37 U/mL) and 29 who had normal levels (≤37 U/mL). Of 45 patients with high CA19-9 levels, 34 had normalized CA19-9 levels after resection and 11 had persistently high levels. Of 34 patients with normalized CA19-9 levels, 18 showed recurrence. Of 29 patients with normal preoperative levels, 15 showed recurrence. Multivariate analysis presented that old age (hazard ratio [HR] = 3.881, p < 0.01), persistently high postoperative CA19-9 level (HR = 4.41, p < 0.001), perineural invasion (HR = 3.073, p = 0.01), narrow resection margin (HR = 3.152, p = 0.05), and lymph node metastasis (HR = 3.427, p = 0.02) were significant independent risk factors for survival. Conclusions. Patients who have normalized CA19-9 levels postoperatively have longer survival outcomes. Therefore, normalized postoperative CA19-9 may be a useful clinical marker for ICC survival.