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在接受胰腺癌切除术的患者中,血清CA19-9的动态

A Floortje van Oosten^1,2, Vincent P Groot¹, Galina Dorland¹

¹Department of Surgery, Regional Academic Cancer Center Utrecht, UMC Utrecht Cancer Center and St. Antonius Hospital, Nieuwegein, The Netherlands.

Annals of surgery

|June 30, 2023

概括

在胰腺癌手术后监测血清碳水化合物抗原19-9 (CA 19-9) 水平的相对增加可以比持续监测更早预测复发. 在CA 19-9的2.6倍增加表明复发,指导及时开始治疗.

科学领域:

在瘤学瘤学.
生物标志物发现发现
手术瘤学手术瘤学

背景情况:

碳水化合物抗原19-9 (CA 19-9) 是胰腺管道腺癌 (PDAC) 的公认预后生物标志物.
在术后监测期间对CA 19-9的监测对于检测PDAC复发和指导治疗的有用性仍然不清楚.

研究的目的:

评估CA 19-9在确定PDAC切除后患者疾病复发中的诊断价值.
确定CA 19-9的动态是否可以作为重复性治疗的早期指标.

主要方法:

在PDAC切除患者的诊断,术后和随访期间分析血清CA 19-9水平.
计算相对术后CA 19-9增加 (最大值 / 第一次术后值).
接收器操作特征 (ROC) 分析,以确定回复预测的最佳门,使用AUC,灵敏度,特异性和预测值进行验证.

主要成果:

手术后CA 19-9的相对增加2.6倍预测了复发,敏感度为58%和特异性为83% (AUC为0.719训练,0.663测试).
这种2.6倍的增加检测到复发平均比成像更早7-10个月.
相对增加标记的表现优于连续的CA 19-9切割值 (AUC 0.671).

结论:

术后CA 19-9相对增加2.6倍是与连续切断相比,PDAC复发的优异预测指标.
CA 19-9的动态可以在成像检测到的复发之前几个月,从而能够更早地进行干预.
监测CA 19-9趋势提供了一种有价值的生物标志物策略,用于指导在PDAC幸存者中启动以复发为重点的治疗.

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