意外胆囊癌组织中糖类抗原19-9和癌胚抗原表达的预后价值  

Prognostic Value of Carbohydrate Antigen19-9 and Carcinoma Embryonic Antigen Expression in Unexpected Gallbladder Carcinoma Tissue

作　　者：章正威 王翔 章应峰 张彤 ZHANG Zheng-wei;WANG Xiang;ZHANG Ying-feng(Department of Hepatobiliary and Pancreatic Surgery,Xinghua People’s Hospital Affiliated of Yangzhou University,Xinghua,Jiangsu,225700,China)

机构地区：[1]扬州大学附属兴化市人民医院肝胆胰外科,江苏兴化225700

出　　处：《黑龙江医学》2023年第4期389-392,共4页Heilongjiang Medical Journal

基　　金：江苏大学2021年度临床医学科技发展基金项目(JLY2021196,JLY2021198)。

摘　　要：目的:通过检测意外胆囊癌(unexpected gallbladder carcinoma,UGC)组织中糖类抗原19-9 (carbohydrate antigen 19-9,CA19-9)和癌胚抗原(carcinoma embryonic antigen,CEA)的水平,阐明CA19-9和CEA表达对UGC术后患者预后判断的临床意义。方法:选取2012年1月—2021年1月扬州大学附属兴化市人民医院收治的48例胆囊切除术中或术后发现UGC患者作为研究对象。采用免疫组织化学法,检测48例UGC组织中CA19-9和CEA的表达,并分析两者表达与其临床病理参数和预后的关系。用Spearman分析法比较患者基本特征及与术后复发的关系;用多因素生存分析评价手术及临床、病理特征的预后影响。结果:pT1b~pT4期UGC患者生存与肿瘤pT分期、手术方式(HR=0.173,P<0.001)及组织CA19-9表达(HR=2.211,P<0.001)有关。CA19-9组织表达阳性与术后CA19-9血清水平升高(r=0.417,P<0.001)及术后早期复发(r=0.456,P=0.020)相关。组织CEA表达与术后早期复发(r=0.246,P=0.103)及患者生存(HR=1.301,P=0.286)不相关。结论:CA19-9组织表达阳性pT1b~pT4期UGC患者总体生存更差,早期复发率更高,应对这类UGC患者进行积极的随访管理。Objective:To elucidate the clinical significance of carbohydrate antigen 19-9(CA19-9) and carcinoma embryonic antigen(CEA) expression on the prognosis of patients with unexpected gallbladder carcinoma(UGC) after surgery by measuring the levels of CA19-9 and CEA in UGC tissues.Methods:48 patients admitted to the hospital from January 2012 to January 2021 who were found to have UGC during or after cholecystectomy were selected as the study population. The expression of CA19-9 and CEA in 48 UGC tissues was detected by immunohistochemistry, and the relationship between the expression of both and their clinicopathological parameters and prognosis was analyzed. Spearman analysis was used to compare basic patient characteristics and the relationship with postoperative recurrence. Multifactorial survival analysis was used to evaluate the prognostic impact of surgical and clinical and pathological characteristics.Results:Survival of UGC patients with stage pT1b to pT4 was associated with tumor pT stage, surgical approach(HR=0.173, P<0.001) and tissue CA19-9 expression(HR=2.211, P<0.001). Positive CA19-9 tissue expression was associated with increased postoperative CA19-9 serum levels(r=0.417, P<0.001) and early postoperative recurrence(r=0.456, P=0.020). Tissue CEA expression was not associated with early postoperative recurrence(r=0.246, P=0.103) or patient survival(HR=1.301, P=0.286).Conclusion:Patients with CA19-9 tissue expression-positive pT1b to pT4 stage UGC have worse overall survival and higher early recurrence rates, and such UGC patients should be managed with active follow-up.

关 键 词：胆囊 意外胆囊癌 糖类抗原19-9 癌胚抗原 免疫组化 

分 类 号：R575.6[医药卫生—消化系统]