CA 19-9中度升高提示胰腺导管腺癌病人根治性切除术后预后不佳

Moderate elevation of serum CA 19-9 is unfavorable prognostic factor for patients with pancreatic ductal adenocarcinoma after radical rescection

目的：探讨血CA 19-9水平升高程度对胰腺导管腺癌根治术病人预后的影响。方法：回顾性分析2003年1月至2014年12月于我院行胰腺导管腺癌R0切除术240例病人的临床资料及随访结果。将病人按术前CA 19-9升高程度的不同分为正常组（5.0-34.9 U/m L）、轻度升高组（35.0-99.9 U/m L）、中度升高组（100.0-599.9 U/m L）、重度升高组（≥600.0 U/m L）和阴性组（〈5.0 U/m L）,对各组病人进行Kaplan-Meier生存分析,比较各组病人的预后是否有显著性差异。结果：CA 19-9中度升高组病人的平均生存时间最短。对总胆红素〈10 mg/d L的病人分组后,CA 19-9中度升高组病人的平均生存时间与其余各组间均存在显著性差异。结论：术前CA 19-9中度升高（100.0-599.9 U/m L）而非重度升高（≥600.0 U/m L）提示胰腺导管腺癌根治切除术后预后不佳。

Objective To investigate the prognostic effect of serum CA 19-9 level on the patients with pancreatic ductal adenocarcinoma after radical rescection. Methods The clinical data including follow-up of 240 patients with pancreatic ductal adenocarcinoma after R0 rescection from January 2003 to December 2014 in Ruijin Hospital were retrospectively analyzed. The patients were divided into 5 groups based on preoperative serum CA 19-9 level including normal group（5.0-34.9 U/m L）, mild elevation group（35.0-99.9 U/m L）, moderate elevation group（100.0-599.9 U/m L）,severe elevation group（≥600.0 U/m L） and negative group（〈5.0 U/m L）. Kaplan-Meier survival analysis was used to access the prognosis of patients in 5 groups. Results The shortest survival time was found in the patients with moderate elevation of preoperative CA 19-9 which was present with significant differences when excluding the patients with total bilirubin ≥10 mg/d L. Conclusions It was suggested in this study that the unfavorable prognostic factor is moderate elevation of preoperative serum CA 19-9 level（100.0-599.9 U/m L） in the patients with pancreatic ductal adenocarcinoma after radical rescection but not severe elevated（≥600.0 U/m L）.