血清γ-GT及CA199评估肝内胆管细胞癌切除术后预后的价值  

Value of serum γ-GT and CA199 in prognosis assessment of patients with intrahepatic cholangiocarcinoma after resection

作　　者：杨木易 俞鹏 胡雄伟 洪智贤 YANG Muyi;YU Peng;HU Xiongwei;HONG Zhixian(Department of Hepatic Surgery,the Fifth Medical Center of PLA General Hospital,Beijing 100071,China)

机构地区：[1]解放军总医院第五医学中心肝病外科,北京100071

出　　处：《肝胆胰外科杂志》2023年第6期343-347,共5页Journal of Hepatopancreatobiliary Surgery

摘　　要：目的探讨血清γ-谷氨酰转肽酶(γ-GT)及糖类抗原199(CA199)在评估肝内胆管细胞癌(ICC)行根治性切除术的预后价值。方法回顾性收集2018年5月至2020年5月解放军总医院第五医学中心行根治性手术切除并病理证实为ICC患者68例的临床及随访资料。依据其术前血清γ-GT及CA199值的高低,将入组患者分为高/低γ-GT组及高/低CA199组。采用Kaplan-Meier法进行生存分析,采用Log-rank、多因素Cox比例风险回归模型分析评估血清CA199及γ-GT是否为独立预后因素。结果术前高γ-GT组患者的中位无复发生存时间短于低γ-GT组(16.0个月vs 25.3个月,P<0.01)。术前高CA199组患者的中位无复发生存时间短于低CA199组(13.0个月vs 20.5个月,P<0.01)。多因素分析显示,γ-GT(RR=6.741,95%CI3.129-14.520,P<0.01)及CA199(RR=5.015,95%CI 2.595-9.692,P<0.01)是影响ICC患者切除术后预后的独立危险因素。结论高水平血清γ-GT及CA199是ICC切除术后预后较差的独立危险因素,联合检测血清γ-GT及CA199水平对评估ICC切除术后患者的预后有重要临床意义。Objective To evaluate the prognostic value of γ-glutamyltranspeptidyase(γ-GT)and serum carbohydrate antigen 199(CA199)in patients with radical resection of intrahepatic cholangiocarcinoma(ICC).Methods From May 2018 to May 2020,the clinical data of 68 patients with ICC confirmed by pathology who underwent radical surgical resection in the Fifth Medical Center of PLA General Hospital were retrospectively analyzed.According to the preoperative serum γ-GT and CA199 levels,the enrolled patients were divided into high/low γ-GT group and high/low CA199 group.Kaplan-Meier method was used for survival analysis,and Logrank and Cox proportional hazard regression models were used to evaluate whether serum γ-GT and CA199 were independent prognostic factors.Results The median disease free survival time of patients in the high γ-GT group before surgery was lower than that in the low γ-GT group(16.0 months vs 25.3 months,P<0.01),and the same results were achieved in the CA199 group(13.0 months vs 20.5 months,P<0.01).Multivariate analysis showed that γ-GT(RR=6.741,95%CI 3.129-14.520,P<0.01)and CA199(RR=5.015,95%CI 2.595-9.692,P<0.01)were independent factors affecting the prognosis of patients with ICC after resection.Conclusion High serum γ-GT and CA199 are independent risk factors for poor prognosis,in patients with ICC after resection.The joint detection of serumγ-GT and CA199 levels is of great clinical significance in evaluating the prognosis of patients with ICC after resection.

关 键 词：肝内胆管细胞癌 肝切除术 γ-谷氨酰转肽酶(γ-GT) 糖类抗原199(CA199) 预后 

分 类 号：R735.7[医药卫生—肿瘤]