摘要
目的探讨血清癌胚抗原(CEA)、糖类抗原125(CA125)联合糖类抗原199(CA199)对晚期肝内胆管细胞癌(ICC)预后的预测作用。方法回顾性分析2015年1月~2018年1月医院收治的120例ICC患者的临床资料,根据随访1年内病情是否进展和死亡将患者分别纳入预后良好组和不良组;对比预后良好组和不良组患者血清CEA、CA125、CA199水平,并对比2组其他可能导致预后不良影响因素的差异,采用Logistic回归分析法明确相关危险因素;绘制受试者工作曲线(ROC),分析血清CEA、CA125、CA199检测及联合检测对晚期ICC患者预后不良的预测意义。结果随访1年内,共91例患者发生预后不良,其中72例死亡、19例进展生存,预后不良发生率为75.83%。预后不良组血清CEA、CA125、CA199水平高于预后良好组,且差异均有统计学意义(P<0.05);2组性别、年龄、肿瘤直径、合并肝炎、合并肝硬化、Child-Pugh分级、治疗方式、不同血AFP水平患者构成比比较,差异均无统计学意义(P>0.05),预后不良组多发肿瘤、低度分化、TBIL>171μmol/mL患者构成比均高于预后良好组,且差异均有统计学意义(P<0.05);经Logistic回归分析发现,CEA>9.67 ng/mL、CA125>93.23 U/mL、CA199>120.11 U/mL、多发肿瘤、低度分化、TBIL>171μmol/mL均是导致晚期ICC患者预后不良的独立危险因素(P<0.05);血清CEA、CA125、CA199预测晚期ICC患者预后不良最佳截断点分别为9.67 ng/mL、93.23 U/mL、120.11 U/mL;血清CEA、CA125、CA199联合检测预测预后不良的灵敏度、特异度和准确度均高于单独检测,且联合检测预测预后不良的AUC为0.832,高于单独检测。结论CEA、CA125、CA199与晚期ICC患者预后不良关系密切,且与单独检测血清CEA、CA125、CA199相比,联合检测3种血清学指标对晚期ICC患者预后预测价值更高。
Objective To investigate the predictive role of serum carcinoembryonic antigen(CEA),carbohydrate antigen 125(CA125)and carbohydrate antigen 199(CA199)in prediction of the prognosis of advanced intrahepatic cholangiocarcinoma(ICC).Methods The clinical data of 120 patients with ICC in the hospital between 2015 and 2018 were retrospectively analyzed.The patients were divided into good prognosis and poor prognosis according to the disease progression and time of survival in one year follow-up.Logistic regression analysis was used to identify the related risk factors.Subject working curve was drawn,and the predictive significance of serum CEA,CA125,and CA199 was analyzed.Results Ninety-one patients had poor prognosis,including 72 deaths and 19 survivals with disease progression.The incidence of poor prognosis was 75.83%,with high levels of serum CEA,CA125 and CA199(P<0.05).There were no significant differences between the two groups in gender,age,tumor diameter,hepatitis,cirrhosis,Child-Pugh classification,treatment methods as well as the blood AFP concentration(P>0.05).The independent risk factors for the patients with poor prognosis include multiple tumors,low differentiation and high TBIL≥171μmol/mL(P<0.05).Logistic regression analysis showed that elevated CEA(>9.67 ng/mL),CA125(>93.23 U/mL),CA199(>120.11 U/mL),and TBIL(>171 mmol/mL)and multiple tumors with low differentiation were independent risk factors for poor prognosis in patients with advanced ICC(P<0.05).The best cut-off points of serum CEA,CA125 and CA199 for predicting poor prognosis were 9.67 ng/mL,93.23 U/mL and 120.11 U/mL,respectively.The sensitivity,specificity and accuracy of combined detections of serum CEA,CA125 and CA199 were higher than those of single detection,and the AUC of combined detection was 0.832,higher than that of single detection.Conclusion The serum levels of CEA,CA125 and CA199 are closely related to poor prognosis in patients with advanced ICC,and compared with the serum CEA,CA125 and CA199 detected alone,the serological indica
作者
李晓洁
慈雪萍
张俊
LI Xiao-jie;CI Xu-ping;ZHANG Jun(Lu'an Hospital of Traditional Chinese Medicine,230076)
出处
《临床输血与检验》
CAS
2020年第4期434-439,共6页
Journal of Clinical Transfusion and Laboratory Medicine
关键词
癌胚抗原
糖类抗原125
糖类抗原199
晚期肝内胆管细胞癌
预后
Carcinoembryonic antigen
Carbohydrate antigen125
Carbohydrate antigen 199
Advanced intrahepatic cholangiocarcinoma
Prognosis
