术前血清CA19-9联合CA125对肝内胆管癌术后病人预后预测价值研究  

The predictive value of preoperative serum CA19-9 combined with CA125 for the prognosis of patients with intrahepatic cholangiocarcinoma

作　　者：赵莹[1] 廖冰[2] 陈伟[1] 张一帆 赖佳明[1] 黄力[1] 梁力建[1] 殷晓煜[1] 陈东[1] ZHAO Ying;LIAO Bing;CHEN Wei(Department of Pancreato-Biliary Surgery,the First Affiliated Hospital of Sun Yatsen University,Guangzhou 510080,China;不详)

机构地区：[1]中山大学附属第一医院胆胰外科,广东广州510080 [2]中山大学附属第一医院病理科,广东广州510080

出　　处：《中国实用外科杂志》2020年第8期932-938,共7页Chinese Journal of Practical Surgery

基　　金：国家自然科学基金(No.81402504);广东省自然科学基金(N0.1914050001553)。

摘　　要：目的评估术前血清CA19-9联合CA125水平对肝内胆管癌(ICC)根治术后病人预后的预测价值。方法回顾性分析2013年2月至2019年8月在中山大学附属第一医院行根治性手术切除,且术后病理学检查确诊为ICC的145例病人的临床病理及随访资料。采用Kaplan-Meier法,单因素和多因素COX比例风险模型分析预后相关的独立危险因素。比较不同CA19-9、CA125水平ICC病人的临床特征。结果单因素及多因素分析提示术前血清CA19-9及CA125水平都是ICC预后的独立危险因素(P=0.032,P=0.029)。根据术前CA19-9和CA125是否为阳性[CA19-9>37 kU/L为CA19-9(+),CA19-9≤37 kU/L为CA19-9(-),CA125>35 kU/L为CA125(+),CA125≤35 kU/L为CA125(-)]分组结果显示:CA19-9(+)/CA125(+)组病人预后明显低于CA19-9(-)/CA125(-)或CA19-9(+)/CA125(-)组(P<0.001,P=0.008)。不论CA19-9(+)或CA19-9(-),CA125(+)病人肿瘤TNM分期较差(P=0.023,P=0.005)。结论术前血清CA19-9联合CA125水平可更好的预测ICC病人的预后,原因可能与术前血清CA125阳性ICC病人TNM分期处于更晚期有关。Objective To assess the value of preoperative serum CA19-9 combined with CA125 in evaluating the survival among intrahepatic cholangiocarcinoma(ICC) patients who underwent radical resection.Methods Retrospective analysis was performed on the clinicopathological and follow-up data of 145 patients who underwent curative-intent resection in the First Affiliated Hospital,Sun Yat-sen University and were pathologically confirmed as ICC from February2013 to August 2019.Independent prognostic risk factors were analyzed by using Kaplan-Meier method,univariate and multivariate Cox proportional risk models.Chi-square test was used to compare the clinical characteristics of ICC patients with different levels of CA19-9 and CA125.Results Univariate and multivariate analysis suggested that both CA 19-9 and CA125 were independent risk factors for the survival of ICC patients underwent radical resection(P=0.032,P=0.029).The prognosis of patients in the CA19-9(+)/CA125(+)group was significantly lower when compared with the CA19-9(-)/CA125(-)or CA19-9(+)/CA125(-)groups,respectively(P<0.001,P=0.008).And regardless of in the CA19-9(+) or CA19-9(-) group,patients with CA125(+)-were in a more advanced tumor TNM stage(P=0.023,P=0.005).Conclusion Combination of preoperative serum CA19-9 and CA125 level can better predict the prognosis of ICC patients by the fact that CA125 positive ICC patients are in more advanced TNM stage.

关 键 词：肝内胆管癌 糖类抗原19-9 糖类抗原125 预后 

分 类 号：R6[医药卫生—外科学]