Combining prognostic value of serum carbohydrate antigen 19-9 and tumor size reduction ratio in pancreatic ductal adenocarcinoma

BACKGROUND Pancreatic ductal adenocarcinoma(PDAC)is a common cancer with increasing morbidity and mortality due to changes of social environment.AIM To evaluate the significance of serum carbohydrate antigen 19-9(CA19-9)and tumor size changes pre-and post-neoadjuvant therapy(NAT).METHODS This retrospective study was conducted at the Chongqing Key Laboratory of Translational Research for Cancer Metastasis and Individualized Treatment,Chongqing University Cancer Hospital.This study specifically assessed CA19-9 levels and tumor size before and after NAT.RESULTS A total of 156 patients who completed NAT and subsequently underwent tumor resection were included in this study.The average age was 65.4±10.6 years and 72(46.2%)patients were female.Before survival analysis,we defined the post-NAT serum CA19-9 level/pre-NAT serum CA19-9 level as the CA19-9 ratio(CR).The patients were divided into three groups:CR<0.5,CR>0.5 and<1 and CR>1.With regard to tumor size measured by both computed tomography and magnetic resonance imaging,we defined the post-NAT tumor size/pre-NAT tumor size as the tumor size ratio(TR).The patients were then divided into three groups:TR<0.5,TR>0.5 and<1 and TR>1.Based on these groups divided according to CR and TR,we performed both overall survival(OS)and disease-free survival(DFS)analyses.Log-rank tests showed that both OS and DFS were significantly different among the groups according to CR and TR(P<0.05).CR and TR after NAT were associated with increased odds of achieving a complete or near-complete pathologic response.Moreover,CR(hazard ratio:1.721,95%CI:1.373-3.762;P=0.006),and TR(hazard ratio:1.435,95%CI:1.275-4.363;P=0.014)were identified as independent factors associated with OS.CONCLUSION This study demonstrated that post-NAT serum CA19-9 level/pre-NAT serum CA19-9 level and post-NAT tumor size/pre-NAT tumor size were independent factors associated with OS in patients with PDAC who received NAT and subsequent surgical resection.

Carbohydrate antigen 19-9 — tumor marker: Past, present, andfuture

Carbohydrate antigen 19-9 (CA 19-9) is a cell surface glycoprotein complex mostcommonly associated with pancreatic ductal adenocarcinoma (PDAC). Koprowskifirst described it in 1979 using a mouse monoclonal antibody in a colorectalcarcinoma cell line. Historically, it is one of the most commonly used tumormarkers for diagnosing, managing, and prognosticating PDAC. Additionally,elevated CA 19-9 levels are used as an indication for surgery in suspected benignpancreatic conditions. Another common application of CA 19-9 in the biliary tractincludes its use as an adjunct in diagnosing cholangiocarcinoma. However, itsclinical value is not limited to the hepatopancreatobiliary system. The reality isthat the advancing literature has broadened the clinical value of CA 19-9. Thepotential value of CA 19-9 in patients' workup extends its reach to gastrointestinalcancers – such as colorectal and oesophageal cancer – and further beyond thegastrointestinal tract - including urological, gynecological, pulmonary, andthyroid pathologies. Apart from its role in investigations, CA 19-9 presents apotential therapeutic target in PDAC and acute pancreatitis. In a bid toconsolidate its broad utility, we appraised and reviewed the biomarker’s currentutility and limitations in investigations and management, while discussing thepotential applications for CA 19-9 in the works for the future.

Carbohydrate antigen 19-9 as a novel prognostic biomarker in distal cholangiocarcinoma

BACKGROUND Distal cholangiocarcinoma(DCC)presents as one of the relatively rare malignant tumors in the digestive system and has a poor long-term prognosis.Curative resection is currently the most appropriate therapy for patients with DCC because of the lack of effective adjuvant therapies.Therefore,it is important to accurately predict the prognosis for formulating a reasonable treatment plan and avoiding unnecessary surgical trauma.AIM To minimize the interference of obstructive jaundice on carbohydrate antigen 19-9(CA19-9)level by adapting CA19-9 toγ-glutamyltransferase(GGT)as an indicator,to determine the strong associations between CA19-9/GGT and postoperative neoplasm recurrence and long-term outcome of DCC.METHODS We enrolled 186 patients who were diagnosed with DCC between January 2010 and December 2019 and performed radical excision with strict criteria as follows in our hospital.Receiver operating characteristic curves were drawn according to preoperative CA19-9/GGT and 1-year survival.Based on this,patients were divided into two groups(group 1,low-ratio,n=81;group 2,high-ratio,n=105).Afterwards,by the way of univariate and multivariate analysis,the risk factors influencing postoperative tumor recrudesce and long-term prognosis of patients with DCC were screened out.RESULTS Optimum cut-off value of CA19-9/GGT was 0.12.Patients in group 2 represented higher CA19-9 and lymphatic metastasis rate accompanied by lower GGT,when compared with group 1(P<0.05).The 1-,3-and 5-year overall survival rates of patients in groups 1 and 2 were 88.3%,59.2%and 48.1%,and 61.0%,13.6%and 13.6%,respectively(P=0.000).Multivariate analysis indicated that CA19-9/GGT,lymphatic metastasis and tumor differentiation were independent risk factors for tumor recurrence and long-term prognosis of DCC.CONCLUSION Elevation of CA19-9/GGT performed better as a biomarker of aggressive carcinoma and predictor of poor clinical outcomes by reducing the effect of obstruction of biliary tract on CA19-9 concentration in patients with DCC.

Clinical characteristics and outcomes in carbohydrate antigen 19-9 negative pancreatic cancer

BACKGROUND Pancreatic ductal adenocarcinoma(PDAC)is a leading cause of death from cancer worldwide.Tumor markers like carbohydrate antigen 19-9(CA 19-9)have been proven valuable as a diagnostic tool and a predictor for tumor staging and response to therapy.AIM To delineate the phenotype of normal CA 19-9 PDAC according to clinical features,disease staging and prognosis as compared with high CA 19-9 PDAC cases.METHODS We performed a retrospective single-center analysis of all PDAC cases admitted in our Gastroenterology department over a period of 30 mo that were diagnosed by endoscopic ultrasound-guided tissue acquisition.Patients were divided into two groups according to CA 19-9 levels over a threshold of 37 U/mL.We performed a comparison between the two groups with regard to demographic and clinical data,biomarkers,tumor staging and 6-mo survival.RESULTS Altogether 111 patients were recruited with 29 having documented normal CA 19-9(<37 U/mL).In the CA 19-9 negative group of patients,20.68%had elevated levels of both CEA and CA 125,13.79%for CA 125 only whilst 17.24%for CEA only.The two groups had similar demographic characteristics.Abdominal pain was more frequently reported in positive vs negative CA 19-9 PDAC cases(76.83%vs 55.17%),while smoking was slightly more prevalent in the latter group(28.04%vs 31.03%).Tumors over 2 cm were more frequently seen in the positive CA 19-9 group,reflecting a higher proportion of locally advanced and metastatic neoplasia(87.7%vs 79.3%).Sixmonth survival was higher for the negative CA 19-9 group(58.62%vs 47.56%).CONCLUSION Elevated CA 19-9 at diagnosis seems to be associated with a more pronounced symptomatology,high tumor burden and poor prognosis compared to negative CA 19-9 PDAC cases.CEA and CA 125 can be adjunctive useful markers for PDAC,especially in CA 19-9 negative cases.

Preoperative serum carbohydrate antigen 19-9 levels predict early recurrence after the resection of early-stage pancreatic ductal adenocarcinoma

BACKGROUND Pancreatic ductal adenocarcinoma(PDAC)is a serious disease with a poor prognosis.Only a minority of patients undergo surgery due to the advanced stage of the disease,and patients with early-stage disease,who are expected to have a better prognosis,often experience recurrence.Thus,it is important to identify the risk factors for early recurrence and to develop an adequate treatment plan.AIM To evaluate the predictive factors associated with the early recurrence of earlystage PDAC.METHODS This study enrolled 407 patients with stage I PDAC undergoing upfront surgical resection between January 2000 and April 2016.Early recurrence was defined as a diagnosis of recurrence within 6 mo of surgery.The optimal cutoff values were determined by receiver operating characteristic(ROC)analyses.Univariate and multivariate analyses were performed to identify the risk factors for early recurrence.RESULTS Of the 407 patients,98 patients(24.1%)experienced early disease recurrence:26(26.5%)local and 72(73.5%)distant sites.In total,253(62.2%)patients received adjuvant chemotherapy.On ROC curve analysis,the optimal cutoff values for early recurrence were 70 U/mL and 2.85 cm for carbohydrate antigen 19-9(CA 19-9)levels and tumor size,respectively.Of the 181 patients with CA 19-9 level>70 U/mL,59(32.6%)had early recurrence,compared to 39(17.4%)of 226 patients with CA 19-9 level≤70 U/mL(P<0.001).Multivariate analysis revealed that CA 19-9 level>70 U/mL(P=0.006),tumor size>2.85 cm(P=0.004),poor differentiation(P=0.008),and non-adjuvant chemotherapy(P=0.025)were significant risk factors for early recurrence in early-stage PDAC.CONCLUSION Elevated CA 19-9 level(cutoff value>70 U/mL)can be a reliable predictive factor for early recurrence in early-stage PDAC.As adjuvant chemotherapy can prevent early recurrence,it should be recommended for patients susceptible to early recurrence.

Neutrophil-to-lymphocyte ratio and carbohydrate antigen 19-9 as prognostic markers for advanced pancreatic cancer patients receiving first-line chemotherapy

BACKGROUND A decline in serum carbohydrate antigen 19-9(CA19-9)levels during systemic chemotherapy is considered as a prognostic marker for patients with advanced pancreatic cancer.Neutrophil-to-lymphocyte ratio(NLR)has been extensively studied as a simple and useful indicator of prognosis in various cancers including pancreatic cancer.AIM To assess the prognostic significance of NLR and CA19-9 in patients with advanced pancreatic adenocarcinoma received first-line chemotherapy according to CA19-9 positivity.METHODS We retrospectively analyzed patients diagnosed with advanced pancreatic cancer who received first-line chemotherapy between January 2010 and July 2017 at the Catholic University of Seoul St.Mary’s Hospital.Patients were divided according to CA19-9 positivity(CA19-9-positive vs-negative groups)and pre-and posttreatment NLR levels.To determine cut-off value of NLR and CA19-9 reduction,time-dependent receiver operating characteristic curve was applied.We evaluated overall survival(OS)and progression-free survival(PFS)for each group using Kaplan-Meier method,and we performed multivariate analyses on the entire cohort.RESULTS We included 271 patients in this study.Cut-off value of NLR and CA19-9 reduction was determined as 2.62 and 18%.Multivariate analysis showed that post-treatment NLR<2.62 and reduction of≥18%of baseline CA19-9 were significantly associated with OS and PFS.Post-treatment NLR≥2.62 showed hazard ratio(HR)of 2.47[95%confidence interval(CI):1.84-3.32,P<0.001]and CA19-9 decline(≥18%)showed HR of 0.51(95%CI:0.39-0.67,P<0.001)for OS.When CA19-9-positive patients were divided into groups according to CA19-9 response(responder vs non-responder)and post-treatment NLR(<2.62 vs≥2.62),CA19-9 responder and post-treatment NLR<2.62 group showed better survival than CA19-9 non-responder and post-treatment NLR≥2.62 group(OS 11.0 mo vs 3.9 mo,P<0.001;PFS 6.3 mo vs 2.0 mo,P<0.001).The combination of CA19-9 decline and post-treatment NLR showed a significant correlation with clinical response in CA 19-9 positive group.Within the CA19-9-negative group,the posttreatment NLR<2.62 group showed better survival than the post-treatment NLR≥2.62 group(OS 12.7 mo vs 7.7 mo,P<0.001;PFS 6.7 mo vs 2.1 mo,P<0.001),and post-treatment NLR showed correlation with clinical response.CONCLUSION In advanced pancreatic cancer patients positive for CA19-9 and treated with systemic chemotherapy,the combination of post-treatment NLR<2.62 and 18%decline of CA19-9 at the first response evaluation is a good prognostic marker.Post-treatment NLR<2.62 alone could be used as a prognostic marker and an adjunctive tool for response evaluation in CA19-9-negative patients.

High level of preoperative carbohydrate antigen 19-9 is a poor survival predictor in gastric cancer

AIM:To assess the clinical significance and the prognostic value of preoperative serum carbohydrate antigen 19-9(CA 19-9)level in gastric cancer.METHODS:Between January 2005 and December2006,1960 patients underwent surgery for histologically confirmed gastric cancer.Of these,163 patients had elevated serum levels of CA 19-9 preoperatively,and1628 patients had normal serum levels of CA 19-9 preoperatively.For this study,325 patients were selected from the group of 1628 patients by age,sex,and cancer stage to serve as controls.Statistically significant differences in survival rates were calculated using the log-rank test.A P value less than 0.05 was considered statistically significant and was determined using SAS software.RESULTS:The baseline characteristics showed some differences between the two groups with regard to histology.Overall survival(OS)in the elevated and nonelevated group was 37.90 and 68.67 mo,respectively(P<0.001).N stage(P=0.001)was a significant predictor of disease-free survival by multivariate analysis.Also,N stage(P<0.001),and the presence of peritoneal metastasis(P<0.001)remained independent factors in predicting OS by multivariate analysis.Additionally,preoperative serum CA 19-9 levels were significantly associated with OS in univariate(P=0.009)and multivariate(P=0.021)analyses.CONCLUSION:Serum CA 19-9 can be considered an independent prognostic factor in predicting OS in patients anticipating surgery for gastric cancer.

Detection of pancreatic cancer with normal carbohydrate antigen 19-9 using protein chip technology

AIM:To develop a method to differentiate pancreatic cancer patients from healthy or benign individuals when carbohydrate antigen(CA)19-9 is normal.METHODS:Forty-one serum samples from patients with pancreatic lesions and blood samples from 20 healthy individuals were collected at the first stage of the experiment according to the enrolment criteria.General characteristics and some clinical features were carefully compared to ensure that the results were reasonable.All the blood samples were analyzed by surface-enhanced laser desorption/ionization time-of-flight mass spectrometry(SELDI-TOF-MS)combined with CM10 chips and a related bioinformatics analysis program to generate diagnostic models with different proteins.Forty-seven consecutive samples were tested at the next stage to verify the veracity and efficiency of the models.RESULTS:The sex,age,and serum CA19-9 levels among the three groups(malignant,benign,and healthy)were statistically matched(P values were 0.957,0.145,and 0.382,respectively).Two patterns were generated.Pattern 1 with four proteins theoretically had a specificity and sensitivity of 100%in distinguishing pancreatic cancer from healthy individuals,while it was 86.7%and86.4%,respectively,in the subsequent practical verification.The positive predictive value(PPV)of the model was86.4%.One of the four proteins was expressed highly in pancreatic cancer while the other three were expressed weakly.Pattern 2 consisted of six proteins that showed a specificity of 70.0%and sensitivity of 77.3%for differentiating malignancy from benign tumors.Its PPV reached85.0%.Only one of these six proteins showed high expression in the malignant group.CONCLUSION:SELDI-TOF-MS may facilitate diagnosis or differential diagnosis of pancreatic cancer when CA19-9 is normal.Pattern 1 may serve as a useful screening tool.

Prognostic significance of SUVmax and serum carbohydrate antigen 19-9 in pancreatic cancer

AIM:To investigate the prognostic significance of pretreatment standardized maximum uptake value(SUVmax)and serum carbohydrate antigen(CA)19-9 in pancreatic cancer.METHODS:From January 2007 to October 2011,80 consecutive patients with pancreatic cancer who received positron emission/computed tomography before any treatment were enrolled in this study.The pretreatment SUVmax and CA19-9 level of the primary pancreatic tumor were obtained and compared with clinicopathological and prognostic factors.Student’s t test for unpaired data was used to analyze the differences between two groups.Univariate analysis and Cox proportional hazards regression were used to examine the independent effects of each significant variable.Survival was analyzed by the Kaplan-Meier method.RESULTS:There was a significant correlation between both the SUVmax and serum CA19-9 of pancreatic cancer and R0 surgical resection(P=0.043 and P=0.007).Lymph node metastasis was associated with SUVmax(P=0.017),but not serum CA19-9(P=0.172).On the contrary,the tumor stage was significantly related to serum CA19-9(P=0.035),but not SUVmax(P=0.110).The univariate analysis showed that survival time was significantly related to tumor stage(P<0.001),lymph node metastasis(P=0.043),R0 surgical resection(P<0.001),serum CA19-9(P=0.001),SUVmax(P<0.001)and SUVmax plus CA19-9(P=0.002).Multivariate analysis clearly showed that only tumor stage(hazard ratio=0.452;P=0.020)was an independent prognostic factor for overall survival in pancreatic cancer.Higher SUVmax or CA19-9showed worse prognosis.We found that high serum CA19-9 plus SUVmax was the most significant variable.CONCLUSION:Higher pretreatment SUVmax and serum CA19-9 indicates poor prognosis.SUVmax plus serum CA19-9 is the most significant variable in predicting survival.

Endoscopic ultrasonography in patients with elevated carbohydrate antigen 19-9 of obscure origin

AIM:To evaluate the efficacy of endoscopic ultrasonography(EUS) in patients with elevated carbohydrate antigen(CA) 19-9 levels of obscure origin.METHODS:Patients who had visited Pusan National University Hospital because of elevated serum CA 19-9 levels,between January 2007 and December 2009,were retrospectively enrolled.EUS had been performed on all subjects,in addition to routine blood tests,endoscopy,abdominal computed tomography(CT) and other clinical exams,which had not revealed any abnormal findings suggestive of the origin of the elevated CA 19-9 levels.RESULTS:Of the 17 patients,gallbladder sludge was detected in 16 patients(94.1%) and common bile duct sludge was observed in 3 patients(17.6%).After the administration of ursodeoxycholic acid to 12 of the patients with gallbladder sludge,CA 19-9 levels normalized in 6 of the patients after a median of 4.5 mo.CONCLUSION:EUS is a useful diagnostic method for patients with elevated CA 19-9 levels of obscure origin,even if the reason for abnormal levels of this serum marker cannot be determined through prior examinations,including abdominal CT.

Ciliated hepatic foregut cyst with high intra-cystic carbohydrate antigen 19-9 level

A ciliated hepatic foregut cyst(CHFC)is a rare foregut developmental malformation usually diagnosed in adulthood.Five percent of reported cases of CHFC transform into squamous cell carcinoma.We report the presentation,evaluation,and surgical management of a symptomatic 45-year-old male found to have a 6.2 cm CHFC.Contrast tomography-guided fine-needle aspirationdemonstrated columnar,ciliated epithelium consistent with the histologic diagnosis of CHFC.The intracystic levels of carbohydrate antigen(CA)19-9 and carcinoembryonic antigen(CEA)were extremely high(978118U/m L and 973μg/L,respectively).Histologically,the wall of the cyst showed characteristic pseudopapillae lined with a ciliated stratified columnar epithelium,underlying smooth muscle,an outer fibrous layer and no atypia.Immunohistochemistry for CA19-9 and CEA was positive.This is the first case report of a CHFC in which levels of CA 19-9 and CEA were measured.Our findings suggest that a large sized multilocular cyst and elevated cyst CA19-9 and CEA levels do not exclude a CHFC from consideration in the diagnosis.CHFCs should be included in the differential diagnosis of hepatic lesions.Accurate diagnosis of a CHFC is necessary given its potential for malignant transformation,and surgical excision is recommended.

临床特征联合血清CA19-9、HE4对子宫内膜异位症相关卵巢癌症的诊断价值

目的 探讨临床特征联合血清糖类抗原(CA) 19-9、人附睾蛋白4 (HE4)对子宫内膜异位症相关卵巢癌症(EAOC)的诊断价值。方法 选择2020年1月至2022年12月在河南中医药大学第三附属医院接受手术且经术后病理确诊为EAOC的43例患者作为观察组,按照1∶2的比例抽取同期在我院手术且经术后证实为卵巢子宫内膜异位症(OEM)的86例患者作为对照组。比较两组患者的临床资料及血清CA125、CA19-9和HE4水平,采用多因素Logistic回归分析影响EAOC的独立风险因素,并采用受试者工作特征曲线(ROC)分析临床特征、CA19-9和HE4诊断EAOC的价值。结果 观察组患者的CA19-9和HE4水平分别为[20.99 (17.06,32.40)] U/mL和[64.47 (55.93,72.01)] U/mL,明显高于对照组的[4.98(2.18,10.86)] U/mL和[43.39(34.61,52.40)] U/mL,差异均有统计学意义(P<0.05);观察组患者的CA125水平为[59.85 (39.51,92.26)] pmol/L,明略高于对照组的[56.58 (39.80,80.68)] pmol/L,但差异无统计学意义(P>0.05)。经多因素Logistic回归分析结果显示,CA19-9、HE4、年龄、肿瘤最长径是影响EAOC的风险因素(P<0.05)。经ROC分析结果显示,年龄、肿瘤最长径、CA19-9、HE4联合检测的曲线下面积(AUC)为0.958,明显高于单独检测(年龄:0.857;肿瘤最长径:0.767;CA19-9:0.767;HE4:0.808)(P<0.05)。结论 CA19-9、HE4、年龄、肿瘤最长径可用于预测EAOC,联合检测可提高诊断效能。

CEA、CA724、CA19-9、CA125联合检测在胃癌患者中的运用价值

目的观察血清癌胚抗原(CEA)、糖类抗原724(CA724)、糖类抗原19-9(CA19-9)、糖类抗原125(CA125)联合检测对胃癌患者的临床价值。方法选取我院2020年5月至2023年5月收治的176例胃癌患者作为恶性组,按照2∶1配对原则选取同期、同年段88名健康对照作为对照组。比较两组血清CEA、CA724、CA19-9、CA125水平,分析胃癌患者血清各指标与临床病理特征的关系,ROC曲线评估血清各指标联合对胃癌的诊断价值。结果恶性组血清CEA、CA724、CA19-9、CA125水平高于对照组(P<0.05);胃癌患者分化程度、TNM分期、淋巴结转移、远处转移血清CEA、CA724、CA19-9、CA125水平比较,差异有统计学意义(P<0.05);血清CEA、CA724、CA19-9、CA125与分化程度、TNM分期、淋巴结转移、远处转移呈正相关(P<0.05);血清CEA、CA724、CA19-9、CA125联合诊断胃癌的AUC大于各指标单独诊断(P<0.05)。结论胃癌患者血清CEA、CA724、CA19-9、CA125表达较高,与患者分化程度、TNM分期、淋巴结转移、远处转移有关,且联合检测胃癌具有较高参考价值。

构建癌胚抗原、糖类抗原19-9生存模型公式预测结直肠癌患者生存时间

目的构建术前癌胚抗原(CEA)、糖类抗原19-9(CA19-9)模型,预测结直肠癌(CRC)患者的生存时间。方法收集江门市中心医院就诊的313例CRC患者,利用Beckman Access化学发光免疫分析仪检测CRC患者术前血清CEA、CA19-9水平,运用χ^(2)检验评估其与CRC患者临床病理参数的关系,Kaplan-Meier生存分析和Cox多因素分析分别评估CRC患者生存及预后。结果CEA、CA19-9均与CRC患者pT、pN、pM分期,临床Ⅰ、Ⅱ、Ⅲ、Ⅳ分期,进展,复发,脉管浸润,转移部位等因素相关(P<0.05)。CEA升高患者的总生存时间(OS)较CEA正常患者缩短(76.85个月vs 110.83个月,P=0.000)。CA19-9升高患者的OS也有相同趋势(P=0.000)。Cox多因素分析发现CEA、CA19-9是预测CRC患者生存的独立因素(HR分别为2.190和2.874;95%CI分别为1.486~3.225和1.947~4.242;P均<0.05)。联合CEA、CA19-9构建模型公式,赋予CEA正常为0分,CEA升高为1分,CA19-9正常为0分,CA19-9升高为1分,并设CC值=CEA评分+CA19-9评分,结果发现CC值最高患者的OS最短,CC值最低患者的OS最长(P<0.05)。结论构建的CEA、CA19-9模型公式可以有效地预测CRC患者预后。

组织内HIF-1α、骨桥蛋白及血清VEGF、CA19-9水平与结直肠癌患者治疗后2年预后的关系

目的探讨组织内缺氧诱导因子-1α(HIF-1α)、骨桥蛋白及血清血管内皮生长因子(VEGF)、糖类抗原19-9(CA19-9)水平与结直肠癌患者治疗后2年预后的关系。方法选取2021年6月至2023年6月秦皇岛市第一医院收治的140例结直肠癌患者为观察组,另将同期于秦皇岛市第一医院体检的70名健康者为对照组。比较两组组织内HIF-1α、骨桥蛋白及血清VEGF、CA19-9表达情况;比较不同临床病理特征结直肠癌患者HIF-1α、骨桥蛋白、VEGF、CA19-9阳性检出率;以Kaplan-Meier法绘制HIF-1α、骨桥蛋白及血清VEGF、CA19-9阳性、阴性结直肠癌患者治疗后2年生存曲线。结果观察组组织内HIF-1α、骨桥蛋白及血清VEGF、CA19-9阳性表达率分别为74.29%、58.57%、66.43%、45.00%,均显著高于对照组(20.00%、11.43%、35.71%、20.00%),差异均有统计学意义(P<0.05)。TNM分期Ⅲ~Ⅳ期、低分化、有淋巴结转移、有脉管浸润患者HIF-1α阳性检出率、CA19-9阳性检出率均明显高于TNM分期为Ⅰ~Ⅱ期、中高分化、无淋巴结转移、无脉管浸润患者,差异均有统计学意义(P<0.05)。肿瘤直径≥5 cm、TNM分期为Ⅲ~Ⅳ期、低分化、有脉管浸润患者骨桥蛋白阳性检出率均明显高于肿瘤直径<5 cm、TNM分期为Ⅰ~Ⅱ期、中高分化、无脉管浸润患者,差异均有统计学意义(P<0.05)。TNM分期为Ⅲ~Ⅳ期、有淋巴结转移患者VEGF阳性检出率明显高于TNM分期为Ⅰ~Ⅱ期、无淋巴结转移患者,差异均有统计学意义(P<0.05)。Kaplan-Meier生存分析显示HIF-1α、骨桥蛋白、CA19-9阳性检出率越高患者治疗后2年存活率越低(Log-Rank=4.425、5.957、5.220,P=0.035、0.015、0.022);Kaplan-Meier生存分析显示VEGF阳性检出率与治疗后2年存活率无关(Log-Rank=0.032,P=0.858)。结论组织内HIF-1α、骨桥蛋白及血清VEGF、CA19-9在结直肠癌中呈高表达水平,且HIF-1α、骨桥蛋白、CA19-9高表达与患者治疗后2年预后不良有关。

血清CEA、CA125、CA19-9、CA72-4水平对胰腺癌患者预后不良的预测价值

目的:探讨癌胚抗原(CEA)、糖类抗原(CA)125、CA19-9、CA72-4水平对胰腺癌患者预后不良的预测价值。方法:回顾性分析2021年1月至2023年1月该院收治的73例胰腺癌患者的临床资料,患者均采用FP方案(氟尿嘧啶+顺铂)化疗,根据化疗预后将其分为预后良好组22例和预后不良组51例。比较两组化疗前血清CEA、CA125、CA19-9、CA72-4水平,采用Logistic回归分析各指标对预后不良的影响,采用受试者工作特征(ROC)曲线分析血清CEA、CA125、CA19-9、CA72-4水平单独及联合检测对胰腺癌患者预后不良的预测价值。结果:化疗前,预后不良组血清CEA、CA125、CA19-9、CA72-4水平均高于预后良好组,差异有统计学意义(P<0.05);Logistic回归分析显示,化疗前血清CEA、CA125、CA19-9、CA72-4水平升高均是胰腺癌患者预后不良的危险因素(P<0.05);ROC曲线分析结果显示,化疗前血清CEA、CA125、CA19-9、CA72-4水平联合检测预测胰腺癌患者预后不良的曲线下面积为0.889,预测价值高于单项指标检测。结论:血清CEA、CA125、CA19-9、CA72-4水平升高是胰腺癌患者预后不良的危险因素,各指标联合检测对预后不良的预测价值高于单项指标检测。

CEA、CA19-9、CA125、CA72-4水平联合检测在直肠癌诊断中的效能

目的:观察癌胚抗原(CEA)、糖类抗原19-9(CA19-9)、糖类抗原125(CA125)、糖类抗原72-4(CA72-4)水平联合检测在直肠癌诊断中的效能。方法:回顾性分析2021年2月至2023年5月该院收治的78例直肠癌患者的临床资料,作为直肠癌组;回顾性分析同期该院收治的100例直肠良性肿瘤患者(直肠腺瘤55例,直肠异型增生45例)的临床资料,作为非直肠癌组。比较两组CEA、CA19-9、CA125、CA72-4水平,比较不同直肠肿瘤(直肠癌、直肠腺瘤、直肠异型增生)患者CEA、CA19-9、CA125、CA72-4水平,分析CEA、CA19-9、CA125、CA72-4水平单项及联合检测在直肠癌诊断中的效能(灵敏度、特异度、准确度)。结果:直肠癌组血清CEA、CA19-9、CA125、CA72-4水平均高于非直肠癌组,差异有统计学意义(P<0.05)。不同直肠肿瘤患者CEA、CA19-9、CA125、CA72-4水平比较,差异均有统计学意义(P<0.05)。CEA、CA19-9、CA125、CA72-4水平联合检测诊断直肠癌的准确度、灵敏度、特异度均高于四者单项检测诊断,差异有统计学意义(P<0.05)。结论:CEA、CA19-9、CA125、CA72-4水平联合检测诊断直肠癌的效能高于四者单项检测诊断效能。

血清G-17、PGR、CEA、CA19-9及脂联素联合检测在胃癌筛查中的应用研究

目的探讨血清胃泌素-17(G-17)、胃蛋白酶原比值(PGR)、癌胚抗原(CEA)、糖类抗原19-9(CA19-9)及脂联素联合检测在胃癌筛查中的应用价值。方法选取58例胃癌患者作为观察组,同期收治的胃良性疾病患者58例设为对照组。所有患者均采集空腹静脉血检测G-17、PGR、CEA、CA19-9及脂联素水平,比较两组血清学指标差异及不同分期胃癌患者血清学指标变化;并绘制ROC曲线,分析血清G-17、PGR、CEA、CA19-9、脂联素单独检测及联合检测诊断胃癌的临床价值。结果观察组G-17[(16.25±2.18)pmol/L]、CEA[(12.84±2.13)ng/mL]、CA19-9[(42.53±4.28)U/mL]水平高于对照组,PGR[(4.89±0.42)]、脂联素[(5.21±1.05)μg/mL]低于对照组,差异有统计学意义(P<0.05);Ⅰ~Ⅱ期胃癌患者G-17[(14.58±1.69)pmol/L]、CEA[(8.64±1.32)ng/mL]、CA19-9[(36.59±4.02)U/mL]水平低于Ⅲ~Ⅳ期患者,PGR[(6.15±1.02)]、脂联素[(7.02±1.15)μg/mL]高于Ⅲ~Ⅳ期患者,差异有统计学意义(P<0.05);绘制ROC曲线分析显示,G-17、PGR、CEA、CA19-9、脂联素单独检测及联合检测诊断胃癌的曲线下面积(AUC)分别为:0.782、0.775、0.784、0.786、0.722、0.950,联合检测诊断价值最高。结论血清G-17、PGR、CEA、CA19-9及脂联素联合检测在胃癌筛查中应用价值高,可提高诊断效能,便于临床早期筛查工作开展。

CA19-9、NLR在胆囊癌根治手术后患者疾病转归中的临床意义

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。

血清CHI3L1、CA19-9、GP73水平联合检测在肝硬化鉴别诊断中的价值

目的:观察血清壳多糖酶3样蛋白1(CHI3L1)、糖类抗原19-9(CA19-9)、高尔基体蛋白73(GP73)水平联合检测在肝硬化鉴别诊断中的价值。方法:选取2020年4月至2022年7月该院收治的81例肝硬化患者进行横断面研究,设为肝硬化组。选取同期81例肝炎患者进行横断面研究,设为肝炎组。比较两组入院时血清CHI3L1、CA19-9、GP73水平;采用点二列相关性分析对血清CHI3L1、CA19-9、GP73水平与肝硬化的相关性进行分析;绘制ROC曲线,分析血清CHI3L1、CA19-9、GP73水平单项及联合检测鉴别诊断肝硬化的价值。结果:肝硬化组血清CHI3L1、CA19-9、GP73水平均高于肝炎组,差异有统计学意义(P<0.05);点二列相关性分析结果显示,血清CHI3L1、CA19-9、GP73水平与肝硬化呈正相关(r>0,P<0.05);ROC曲线结果显示,入院时血清CHI3L1、CA19-9、GP73水平联合检测诊断肝硬化的曲线下面积(AUC)为0.908,高于三者单项检测诊断(AUC=0.758、0.813、0.724,P<0.05)。结论:血清CHI3L1、CA19-9、GP73水平联合检测诊断肝硬化的价值高于三者单项检测诊断。