术前血清CA19-9水平对原发性十二指肠癌根治术后患者肿瘤复发及预后的评估价值  

VALUE OF PREOPERATIVE SERUM CARBOHYDRATE ANTIGEN 19-9 LEVEL IN EVALUATING TUMOR RECURRENCE AND PROGNOSIS OF PATIENTS AFTER RADICAL SURGERY FOR WITH PRIMARY DUODENAL CARCINOMA

作　　者：文豪 兰瑛瑛 王祖森[3] 姜英俊[4] WEN Hao;LAN Yingying;WANG Zusen;JIANG Yingjun(Department of Hepatobiliary and Pancreatic Surgery, The Affiliated Hospital of Qingdao University, Qingdao 266003, China)

机构地区：[1]青岛大学附属医院肝胆胰外科,山东青岛2660031 [2]青岛大学附属医院肿瘤内科,山东青岛2660031 [3]青岛大学附属医院平度院区普外二科,山东青岛2660031 [4]青岛大学附属医院平度院区普外一科,山东青岛2660031

出　　处：《精准医学杂志》2021年第2期176-180,共5页Journal of Precision Medicine

基　　金：山东省医药卫生科技发展计划(2017WS319)。

摘　　要：目的探讨术前血清CA19-9水平与原发性十二指肠癌(PDC)根治性切除术后患者临床病理特征、预后及肿瘤复发的关系。方法回顾性分析2012年1月1日—2020年9月30日于我院经病理学确诊为PDC并行十二指肠癌根治性手术的209例患者的临床资料,采用Kaplan-Meier绘制患者的生存曲线,采用Pearson卡方检验及Fisher精确检验分析术前血清CA19-9水平与PDC患者临床病理特征的关系,采用Cox风险回归模型分析患者无病生存期(DFS)和总生存期(OS)的影响因素。结果Kaplan-Meier生存曲线显示,术前血清CA19-9水平升高患者较CA19-9水平正常患者的无病生存率和总生存率显著降低(χ^(2)=16.845、12.153,P<0.05)。患者术前血清CA19-9水平与性别、肿瘤T分期、脉管癌栓有关(χ^(2)=3.861~12.134,P<0.05)。单因素分析显示,肿瘤T分期、肿瘤N分期、肿瘤TNM分期、脉管癌栓、神经侵犯、病理分化程度、病理类型、术前血清CA19-9水平与患者DFS显著相关(P<0.05);患者性别、肿瘤T分期、肿瘤N分期、肿瘤TNM分期、脉管癌栓、神经侵犯、病理分化程度、病理类型、术前血清CA19-9水平与患者OS显著相关(P<0.05)。多因素分析显示,术前血清CA19-9水平、肿瘤N分期、神经侵犯、病理分化程度与患者的DFS和OS均显著相关(P<0.05)。结论术前血清CA19-9水平正常患者相较于术前血清CA19-9水平升高患者具有更好的临床预后,术前血清CA19-9水平可作为独立危险因素评估PDC患者的预后与肿瘤复发情况。Objective To investigate the association of preoperative serum carbohydrate antigen 19-9(CA19-9)level with the clinicopathological features,prognosis,and tumor recurrence of patients with primary duodenal carcinoma(PDC)after radical resection.Methods A retrospective analysis was performed for the clinical data of 209 patients with pathologically confirmed PDC who underwent radical surgery for duodenal cancer in our hospital from January 1,2012 to September 30,2020.The Kaplan-Meier method was used to plot the survival curve of the patients,the Pearson chi-square test and the Fisher’s exact test were used to analyze the association between preoperative serum CA19-9 level and clinicopathological features of PDC patients,and a Cox proportional-hazards regression model analysis was used to investigate the influencing factors for the disease-free survival(DFS)and overall survival(OS).Results The Kaplan-Meier survival curve showed that the patients with elevated preoperative serum CA19-9 level had significantly lower DFS and OS rates than those with normal CA19-9 level(χ^(2)=16.845,12.153,P<0.05).Preoperative serum CA19-9 level was associated with sex,tumor T stage,and vascular tumor thrombus(χ^(2)=3.861-12.134,P<0.05).The univariate analysis showed that tumor T stage,tumor N stage,tumor TNM stage,vascular tumor thrombus,perineural invasion,degree of pathological differentiation,pathological type of tumor,and preoperative serum CA19-9 level were significantly associated with DFS(P<0.05),and sex,tumor T stage,tumor N stage,tumor TNM stage,vascular tumor thrombus,perineural invasion,degree of pathological differentiation,pathological type of tumor,and preoperative serum CA19-9 level were significantly associated with OS(P<0.05).The multivariate analysis showed that preoperative serum CA19-9 level,tumor N stage,perineural invasion,and degree of pathological differentiation were significantly associated with DFS and OS(P<0.05).Conclusion Patients with normal preoperative serum CA19-9 level tend to have a better clinical

关 键 词：十二指肠肿瘤 十二指肠切除术 CA19-9抗原 回归分析 无病生存 总生存期 预后 

分 类 号：R735.31[医药卫生—肿瘤]