CA19-9、NLR在胆囊癌根治手术后患者疾病转归中的临床意义  

Clinical significance of CA19-9 and NLR in prognosis of patients with gallbladder cancer after radical surgery

作　　者：王江 崔世昌 陈晓倩 朱慧云 赵伯艳 Wang Jiang;Cui Shichang;Chen Xiaoqian;Zhu Huiyun;Zhao Boyan(Department of Hepatic-Biliary-Pancreatic Surgery,Linyi Central Hospital,Linyi 276400,China;Department of Gastroenterology,Linyi Central Hospital,Linyi 276400,China)

机构地区：[1]临沂市中心医院肝胆胰外科,临沂276400 [2]临沂市中心医院消化内科,临沂276400

出　　处：《国际医药卫生导报》2024年第9期1502-1507,共6页International Medicine and Health Guidance News

基　　金：山东省医药卫生科技发展计划(2018WS392);临沂市社会公益类应用技术成果[临科评备字(2022)第220号]。

摘　　要：目的探讨糖类抗原19-9(carbohydrate antigen 19-9,CA19-9)、中性粒细胞/淋巴细胞比值(neutrophil to lymphocyte ratio,NLR)在胆囊癌根治手术后患者疾病转归中的临床意义。方法选取2015年1月至2021年12月于临沂市中心医院行胆囊癌根治术且均完成1年随访的72例胆囊癌患者为胆囊癌组,其中,男39例,女33例,年龄(63.19±3.85)岁。根据1∶1配对原则,另选取同期72例胆囊息肉患者为对照组,其中,男37例,女35例,年龄(62.54±3.52)岁。比较两组入院时血清CA19-9水平、NLR,比较入院时、术后1周不同疾病转归胆囊癌患者血清CA19-9水平、NLR,比较不同病理学参数胆囊癌患者血清CA19-9水平、NLR。Spearman分析入院时血清CA19-9水平、NLR与病理学参数及疾病转归的相关性。采用受试者操作特征曲线(receiver operating characteristic curve,ROC)分析入院时、术后1周血清CA19-9水平、NLR联合检测对胆囊癌患者转归不良的预测价值。结果入院时,胆囊癌组血清CA19-9水平、NLR均高于对照组[(237.14±38.41)U/ml比(31.87±6.43)U/ml、(4.02±1.25)比(1.84±0.43);均P<0.05]。转归不良患者入院时、术后1周血清CA19-9水平、NLR均高于转归良好患者[(261.71±25.33)U/ml比(218.56±24.52)U/ml、(4.73±1.02)比(3.48±0.75),(181.64±28.58)U/ml比(85.43±12.19)U/ml、(3.37±0.48)比(2.24±0.53);均P<0.05]。不同病理参数胆囊癌患者血清CA19-9水平、NLR比较:中高分化患者低于低分化患者[(208.41±22.83)U/ml比(294.60±23.18)U/ml、(3.14±0.47)比(5.78±0.69)],Ⅰ~Ⅱ期患者低于Ⅲ~Ⅳ期患者[(188.43±25.63)U/ml比(276.11±23.08)U/ml、(2.95±0.57)比(4.88±0.64)],无淋巴结转移的患者低于有淋巴结转移的患者[(206.93±24.25)U/ml比(287.49±16.64)U/ml、(3.38±0.49)比(5.09±0.73)],且两指标水平与组织分化程度(r=-0.698、-0.533)呈负相关,与临床分期(r=0.742、0.659)、淋巴结转移(r=0.701、0.634)、疾病转归(r=0.588、0.719)均呈正相关(均P<0.05)。入院时、术后Objective To explore the clinical significance of carbohydrate antigen 19-9(CA19-9)and neutrophil to lymphocyte ratio(NLR)in the prognosis of patients with gallbladder cancer after radical surgery.Methods Seventy-two patients with gallbladder cancer who underwent radical resection in Linyi Central Hospital from January 2015 to December 2021 and completed one-year follow-up were selected as a gallbladder cancer group,including 39 cases and 33 cases who were(63.19±3.85)years old.According to the 1:1 matching principle,another 72 patients with gallbladder polyps during the same period were selected as a control group,including 37 males and 35 females who were(62.54±3.52)years old.The serum levels of CA19-9 and NLR's were compared between the two groups at admission.The levels of CA19-9 and NLR's were compared between the patients with different outcomes at admission and 1 week after the surgery and between the patients with different pathological parameters.Spearman analysis was used to investigate the correlations of CA19-9 and NLR with pathological parameters and disease outcomes at admission.The receiver operating characteristic curve(ROC)was used to investigate the predictive values of the combined detection at admission and 1 week after surgery for poor outcomes in the patients with gallbladder cancer.Results The serum level of CA19-9 and NLR at admission in the gallbladder cancer group were higher than those in the control group[(237.14±38.41)U/ml vs.(31.87±6.43)U/ml and(4.02±1.25)vs.(1.84±0.43);both P<0.05].The serum levels of CA19-9 and NLR's at admission and 1 week after the surgery in the patients with poor prognosis were higher than those in the patients with good prognosis[(261.71±25.33)U/ml vs.(218.56±24.52)U/ml,(4.73±1.02)vs.(3.48±0.75),(181.64±28.58)U/ml vs.(85.43±12.19)U/ml,and(3.37±0.48)vs.(2.24±0.53);all P<0.05].Comparison of serum level of CA19-9 and NLR between the patients with different pathological parameters:those in the moderately and highly differentiated patients were lower t

关 键 词：胆囊癌 CA19-9 NLR 根治手术 疾病转归 预测价值 

分 类 号：R735.8[医药卫生—肿瘤]