AIM:The diagnosis of cholangiocarcinoma is often difficult,making management approaches problematic. A reliable serum marker for cholangiocarcinoma would be a useful diagnostic test. The aims of our study were to eval...AIM:The diagnosis of cholangiocarcinoma is often difficult,making management approaches problematic. A reliable serum marker for cholangiocarcinoma would be a useful diagnostic test. The aims of our study were to evaluate the usefulness of a serum CA19-9 determination in the diagnosis of cholangiocarcinoma.METHODS: We prospectively measured serum CA19-9 and CEA concentrations in patients with cholangiocarcinoma (n=35), benign biliary diseases (n=92), and healthy individuals (n=15). Serum CA19-9 and CEA concentrations were measured by an immunoradiometric assay without knowledge of the clinical diagnosis.RESULTS:The sensitivity of a CA19-9 value>37KU·L^-1 and a CEA value >22μg·L^-1 in diagnosing cholangiocarcinoma were 77.14% and 68.57%, respectively. When compared with the benign biliary diseases group,the true negative rates of serum CA19-9 and CEA were 84.78% and 81.52%,respectively. The false positive rates of serum CA19-9 and CEA were 15.22% and 18.48%, whereas the accuracy of serum CA19-9 and CEA were 82.68% and 77.95%,respectively. Serum CA19-9 and CEA concentrations were significantly elevated (P<0.001 and P<0.05) in patients with cholangiocarcinoma (290.31±5.34KU·L^-1 and 36.46±18.03μg·L^-1) compared with patients with benign biliary diseases (13.38±2.59KU·L^-1 and 13.84±3.85μg·L^-1) and healthy individuals (12.78±3.69KU·L^-1 and 11.48±3.37μg·L^-1). In 15 patients undergoing curative resection of cholangiocarcinoma,the mean serum CA19-9 concentration was decreased from a preoperative level of 286.41±4.36KU·L^-1 to a postoperative level of 62.01±17.43KU·L^-1 (P<0.001), and the mean serum CEA concentration from 39.41±24.35μg·L^-1 to 28.69±11.03μg·L6-1(P<0.05). In patients with cholangiocarcinoma,however, no correlation was found between serum CEA and CA19-9 concentrations (r=-0.036).CONCLUSION:These data suggest that the serum CA19-9 determination is a useful addition to the available tests for the differential diagnosis of cholangiocarcinoma. Serum CA19-9 is an effective tumor marker in diagnosing cholangiocarcinoma,deciding whether the tumor has been radically resected and monitoring effect of treatment.展开更多
AIM:To evaluate the clinical value of serum CA19-9 levels in predicting the respectability of pancreatic carcinoma according to receiver operating characteristic(ROC) curve analysis. METHODS:Serum CA19-9 levels were m...AIM:To evaluate the clinical value of serum CA19-9 levels in predicting the respectability of pancreatic carcinoma according to receiver operating characteristic(ROC) curve analysis. METHODS:Serum CA19-9 levels were measured in 104 patients with pancreatic cancer which were possible to be resected according to the imaging. ROC curve was plotted for the CA19-9 levels. The point closest to the upper left-hand corner of the graph were chosen as the cut-off point. The sensitivity,specificity,positive and negative predictive values of CA19-9 at this cut-off point were calculated. RESULTS:Resectable pancreatic cancer was detected in 58(55.77%) patients and unresectable pancreatic cancer was detected in 46(44.23%) patients. The area under the ROC curve was 0.918 and 95% CI was 0.843-0.992. The CA19-9 level was 353.15 U/mL,and the sensitivity and specificity of CA19-9 at this cut-off point were 93.1% and 78.3%,respectively. The positive and negative predictive value was 84.38% and 90%,respectively. CONCLUSION:Preoperative serum CA19-9 level is a useful marker for further evaluating the resectability of pancreatic cancer. Obviously increased serum levels of CA19-9(> 353.15 U/mL) can be regarded as an ancillary parameter for unresectable pancreatic cancer.展开更多
Objective To assess the accuracy of preoperative serum CA19-9 levels in predicting the resectability of pancreatic adenocarcinoma.Methods Patients with biopsy-proven pancreatic adenocarcinoma who had preoperative seru...Objective To assess the accuracy of preoperative serum CA19-9 levels in predicting the resectability of pancreatic adenocarcinoma.Methods Patients with biopsy-proven pancreatic adenocarcinoma who had preoperative serum CA19-9 level data were enrolled in the present retrospective analysis. Receiver operating characteristics(ROC) curve analysis was used to determine the optimal cut-off value of CA19-9. The sensitivity, specificity, positive predictive value, and negative predictive value were calculated at this cut-off point.Results Seventy-six patients with pancreatic adenocarcinoma that was considered potentially resectable according to radiological imaging were included. Of all 76 patients, 44 received complete resection of the pancreatic adenocarcinoma. The preoperative serum CA19-9 level was significantly higher in the unresectable tumor group than in the resectable tumor group(P = 0.0036). The area under the ROC curve was 0.749(95% confidence interval [CI]: 0.637–0.842). When the cut-off value of CA19-9 was set to 359.1 U/m L, the sensitivity, specificity, positive and negative predictive values were 71.9%(95% CI: 53.3%–86.3%), 70.5%(95% CI: 54.8%–83.2%), 63.9%(95% CI: 46.0%–79.4%), and 77.5%(95% CI: 61.5%–89.2%), respectively.Conclusion The preoperative serum CA19-9 level is useful for predicting the resectability of pancreatic adenocarcinoma.展开更多
BACKGROUND Gastric cancer is a kind of malignant tumor which is prevalent all over the world.Although some progress has been made in the treatment of gastric cancer,its prognosis is still not optimistic,so it is of gr...BACKGROUND Gastric cancer is a kind of malignant tumor which is prevalent all over the world.Although some progress has been made in the treatment of gastric cancer,its prognosis is still not optimistic,so it is of great significance to find reliable prog-nostic indicators to guide the treatment and management of patients with gastric cancer.AIM To explore the relationship between serum levels of five biomarkers[carcinoem-bryonic antigen(CEA),carbohydrate antigen(CA)19-9,CA72-4,CA24-2,and ferritin]and prognosis in patients with gastric cancer.METHODS This study included 200 patients with gastric adenocarcinoma,and conducted an in-depth analysis of their baseline characteristics,relationship between tumor markers and staging,and prognosis.The study found that CA19-9 has a signi-ficant correlation with tumor stage,the average levels of CA24-2,CEA,CA72-4 and ferritin were slightly increased disregarding the stage of tumor.Survival analysis showed that increases in CEA,CA19-9,CA24-2,and ferritin were all associated with shortened overall survival of patients.Further multivariate ana-lysis revealed that elevated serum CA72-4 levels were an inde-pendent adverse prognostic factor.RESULTS This study reveals that there is a significant correlation between the expression levels of serum tumor markers CEA,CA19-9,CA72-4,CA24-2 and ferritin in patients with gastric cancer and prognosis,and can be used as important indicators for prognostic evaluation of gastric cancer.In particular,markers that appear abnormally elevated initially may help identify gastric cancer patients with poor prognosis.CONCLUSION Serum CEA and CA19-9 play an important role in the prognosis assessment of gastric cancer,and are effective tools to guide clinical practice and optimize individualized treatment strategies for gastric cancer patients.展开更多
BACKGROUND Hepatic metastases are common and difficult to treat after colorectal cancer(CRC)surgery.The predictive value of carcinoembryonic antigen(CEA),cancer antigen(CA)125 and CA19-9 combined tests for liver metas...BACKGROUND Hepatic metastases are common and difficult to treat after colorectal cancer(CRC)surgery.The predictive value of carcinoembryonic antigen(CEA),cancer antigen(CA)125 and CA19-9 combined tests for liver metastasis is unclear.AIM To evaluate predictive value of combined tests for CEA,CA125,and CA19-9 levels in patients with liver metastases of CRC.METHODS The retrospective study included patients with CRC alone(50 cases)and patients with CRC combined with liver metastases(50 cases)who were hospitalized between January 2021 and January 2023.Serum CEA,CA125 and CA19-9 levels were compared between the two groups,and binary logistic regression was used to analyze the predictive value of the combination of these tumor markers in liver metastasis.In addition,we performed receiver operating characteristic(ROC)curve analysis to assess its diagnostic accuracy.RESULTS The results showed that the serum CEA,CA125 and CA19-9 levels in the CRC with liver metastasis group were significantly higher than those in the CRC alone group.Specifically,the average serum CEA level in the CRC with liver metastasis group was 162.03±810.01 ng/mL,while that in the CRC alone group was 5.71±9.76 ng/mL;the average serum CA125 levels were 43.47±83.52 U/mL respectively.and 13.5±19.68 U/mL;the average serum CA19-9 levels were 184.46±473.13 U/mL and 26.55±43.96 U/mL respectively.In addition,binary logistic regression analysis showed that CA125 was significant in predicting CRC liver metastasis(P<0.05).ROC curve analysis results showed that the areas under the ROC curves of CEA,CA125 and CA19-9 were 0.607,0.692 and 0.586.CONCLUSION These results suggest that combined detection of these tumor markers may help early detection and intervention of CRC liver metastasis,thereby improving patient prognosis.展开更多
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...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1周血清CA19-9水平、NLR联合预测胆囊癌患者转归不良的曲线下面积(area under the curve,AUC)分别为0.776(95%CI 0.718~0.839)、0.834(95%CI 0.768~0.906),最佳预测灵敏度分别为87.10%、93.55%,最佳预测特异度分别为68.29%、73.17%。结论CA19-9、NLR在胆囊癌根治术后转归不良患者血清中表达上调,两指标与临床病理参数及疾病转归均有一定相关性。两者联合检测对转归情况具有一定预测价值,可作为临床预测根治术后患者转归情况的辅助指标。展开更多
文摘AIM:The diagnosis of cholangiocarcinoma is often difficult,making management approaches problematic. A reliable serum marker for cholangiocarcinoma would be a useful diagnostic test. The aims of our study were to evaluate the usefulness of a serum CA19-9 determination in the diagnosis of cholangiocarcinoma.METHODS: We prospectively measured serum CA19-9 and CEA concentrations in patients with cholangiocarcinoma (n=35), benign biliary diseases (n=92), and healthy individuals (n=15). Serum CA19-9 and CEA concentrations were measured by an immunoradiometric assay without knowledge of the clinical diagnosis.RESULTS:The sensitivity of a CA19-9 value>37KU·L^-1 and a CEA value >22μg·L^-1 in diagnosing cholangiocarcinoma were 77.14% and 68.57%, respectively. When compared with the benign biliary diseases group,the true negative rates of serum CA19-9 and CEA were 84.78% and 81.52%,respectively. The false positive rates of serum CA19-9 and CEA were 15.22% and 18.48%, whereas the accuracy of serum CA19-9 and CEA were 82.68% and 77.95%,respectively. Serum CA19-9 and CEA concentrations were significantly elevated (P<0.001 and P<0.05) in patients with cholangiocarcinoma (290.31±5.34KU·L^-1 and 36.46±18.03μg·L^-1) compared with patients with benign biliary diseases (13.38±2.59KU·L^-1 and 13.84±3.85μg·L^-1) and healthy individuals (12.78±3.69KU·L^-1 and 11.48±3.37μg·L^-1). In 15 patients undergoing curative resection of cholangiocarcinoma,the mean serum CA19-9 concentration was decreased from a preoperative level of 286.41±4.36KU·L^-1 to a postoperative level of 62.01±17.43KU·L^-1 (P<0.001), and the mean serum CEA concentration from 39.41±24.35μg·L^-1 to 28.69±11.03μg·L6-1(P<0.05). In patients with cholangiocarcinoma,however, no correlation was found between serum CEA and CA19-9 concentrations (r=-0.036).CONCLUSION:These data suggest that the serum CA19-9 determination is a useful addition to the available tests for the differential diagnosis of cholangiocarcinoma. Serum CA19-9 is an effective tumor marker in diagnosing cholangiocarcinoma,deciding whether the tumor has been radically resected and monitoring effect of treatment.
文摘AIM:To evaluate the clinical value of serum CA19-9 levels in predicting the respectability of pancreatic carcinoma according to receiver operating characteristic(ROC) curve analysis. METHODS:Serum CA19-9 levels were measured in 104 patients with pancreatic cancer which were possible to be resected according to the imaging. ROC curve was plotted for the CA19-9 levels. The point closest to the upper left-hand corner of the graph were chosen as the cut-off point. The sensitivity,specificity,positive and negative predictive values of CA19-9 at this cut-off point were calculated. RESULTS:Resectable pancreatic cancer was detected in 58(55.77%) patients and unresectable pancreatic cancer was detected in 46(44.23%) patients. The area under the ROC curve was 0.918 and 95% CI was 0.843-0.992. The CA19-9 level was 353.15 U/mL,and the sensitivity and specificity of CA19-9 at this cut-off point were 93.1% and 78.3%,respectively. The positive and negative predictive value was 84.38% and 90%,respectively. CONCLUSION:Preoperative serum CA19-9 level is a useful marker for further evaluating the resectability of pancreatic cancer. Obviously increased serum levels of CA19-9(> 353.15 U/mL) can be regarded as an ancillary parameter for unresectable pancreatic cancer.
文摘Objective To assess the accuracy of preoperative serum CA19-9 levels in predicting the resectability of pancreatic adenocarcinoma.Methods Patients with biopsy-proven pancreatic adenocarcinoma who had preoperative serum CA19-9 level data were enrolled in the present retrospective analysis. Receiver operating characteristics(ROC) curve analysis was used to determine the optimal cut-off value of CA19-9. The sensitivity, specificity, positive predictive value, and negative predictive value were calculated at this cut-off point.Results Seventy-six patients with pancreatic adenocarcinoma that was considered potentially resectable according to radiological imaging were included. Of all 76 patients, 44 received complete resection of the pancreatic adenocarcinoma. The preoperative serum CA19-9 level was significantly higher in the unresectable tumor group than in the resectable tumor group(P = 0.0036). The area under the ROC curve was 0.749(95% confidence interval [CI]: 0.637–0.842). When the cut-off value of CA19-9 was set to 359.1 U/m L, the sensitivity, specificity, positive and negative predictive values were 71.9%(95% CI: 53.3%–86.3%), 70.5%(95% CI: 54.8%–83.2%), 63.9%(95% CI: 46.0%–79.4%), and 77.5%(95% CI: 61.5%–89.2%), respectively.Conclusion The preoperative serum CA19-9 level is useful for predicting the resectability of pancreatic adenocarcinoma.
文摘BACKGROUND Gastric cancer is a kind of malignant tumor which is prevalent all over the world.Although some progress has been made in the treatment of gastric cancer,its prognosis is still not optimistic,so it is of great significance to find reliable prog-nostic indicators to guide the treatment and management of patients with gastric cancer.AIM To explore the relationship between serum levels of five biomarkers[carcinoem-bryonic antigen(CEA),carbohydrate antigen(CA)19-9,CA72-4,CA24-2,and ferritin]and prognosis in patients with gastric cancer.METHODS This study included 200 patients with gastric adenocarcinoma,and conducted an in-depth analysis of their baseline characteristics,relationship between tumor markers and staging,and prognosis.The study found that CA19-9 has a signi-ficant correlation with tumor stage,the average levels of CA24-2,CEA,CA72-4 and ferritin were slightly increased disregarding the stage of tumor.Survival analysis showed that increases in CEA,CA19-9,CA24-2,and ferritin were all associated with shortened overall survival of patients.Further multivariate ana-lysis revealed that elevated serum CA72-4 levels were an inde-pendent adverse prognostic factor.RESULTS This study reveals that there is a significant correlation between the expression levels of serum tumor markers CEA,CA19-9,CA72-4,CA24-2 and ferritin in patients with gastric cancer and prognosis,and can be used as important indicators for prognostic evaluation of gastric cancer.In particular,markers that appear abnormally elevated initially may help identify gastric cancer patients with poor prognosis.CONCLUSION Serum CEA and CA19-9 play an important role in the prognosis assessment of gastric cancer,and are effective tools to guide clinical practice and optimize individualized treatment strategies for gastric cancer patients.
文摘BACKGROUND Hepatic metastases are common and difficult to treat after colorectal cancer(CRC)surgery.The predictive value of carcinoembryonic antigen(CEA),cancer antigen(CA)125 and CA19-9 combined tests for liver metastasis is unclear.AIM To evaluate predictive value of combined tests for CEA,CA125,and CA19-9 levels in patients with liver metastases of CRC.METHODS The retrospective study included patients with CRC alone(50 cases)and patients with CRC combined with liver metastases(50 cases)who were hospitalized between January 2021 and January 2023.Serum CEA,CA125 and CA19-9 levels were compared between the two groups,and binary logistic regression was used to analyze the predictive value of the combination of these tumor markers in liver metastasis.In addition,we performed receiver operating characteristic(ROC)curve analysis to assess its diagnostic accuracy.RESULTS The results showed that the serum CEA,CA125 and CA19-9 levels in the CRC with liver metastasis group were significantly higher than those in the CRC alone group.Specifically,the average serum CEA level in the CRC with liver metastasis group was 162.03±810.01 ng/mL,while that in the CRC alone group was 5.71±9.76 ng/mL;the average serum CA125 levels were 43.47±83.52 U/mL respectively.and 13.5±19.68 U/mL;the average serum CA19-9 levels were 184.46±473.13 U/mL and 26.55±43.96 U/mL respectively.In addition,binary logistic regression analysis showed that CA125 was significant in predicting CRC liver metastasis(P<0.05).ROC curve analysis results showed that the areas under the ROC curves of CEA,CA125 and CA19-9 were 0.607,0.692 and 0.586.CONCLUSION These results suggest that combined detection of these tumor markers may help early detection and intervention of CRC liver metastasis,thereby improving patient prognosis.
文摘目的探讨糖类抗原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1周血清CA19-9水平、NLR联合预测胆囊癌患者转归不良的曲线下面积(area under the curve,AUC)分别为0.776(95%CI 0.718~0.839)、0.834(95%CI 0.768~0.906),最佳预测灵敏度分别为87.10%、93.55%,最佳预测特异度分别为68.29%、73.17%。结论CA19-9、NLR在胆囊癌根治术后转归不良患者血清中表达上调,两指标与临床病理参数及疾病转归均有一定相关性。两者联合检测对转归情况具有一定预测价值,可作为临床预测根治术后患者转归情况的辅助指标。
