术后血清CYFRA水平在上道尿路癌的预后影响
Yuki Endo1, Jun Akatsuka1, Hayato Takeda1
1Department of Urology, Nippon Medical School.
Journal of Nippon Medical School = Nippon Ika Daigaku zasshi
|September 3, 2025
概括
术后的血清CYFRA21-1 (poCY) 水平可以预测急性瘤切除术 (RNU) 后上道泌尿器癌 (UTUC) 患者的早期进展. 升高的poCY表明风险较高,表明辅助化疗可能有好处.
科学领域:
- 尿瘤学
- 外科瘤学
- 生物标志物研究
背景情况:
- 目前的指导方针不建议在接受激进瘤切除术 (RNU) 的上道泌尿器癌 (UTUC) 患者中使用血清瘤标志物.
- 对于RNU后早期进展,手术后血清C终端细胞素19 (CYFRA21- 1, poCY) 的预后值尚未得到充分确立.
研究的目的:
- 评估术后血清CYFRA21-1 (poCY) 水平作为RNU治疗的UTUC患者早期疾病进展的预测指标的有用性.
- 确定RNU后癌症特异性存活 (CSS) 和无进展存活 (PFS) 的独立预后因素.
主要方法:
- 分析了一组117名用RNU治疗的UTUC患者.
- 根据3. 5 ng/ ml的切割值,患者分为高 (HG) 和低 (LG) 的poCY组.
- 使用卡普兰-梅尔分析,日志等级测试和考克斯比例危险模型来评估CSS和PFS.
主要成果:
- 五年CSS和PFS的比率分别为79%和66%.
- 与LG相比,HG的CSS和2年的PFS显著下降.
- 多变量分析确定poCY,淋巴结参与 (LNI) 和切除边缘状态 (RM) 是早期进展的独立预后因素.
结论:
- 术后的CYFRA21- 1 (poCY),LNI和RM是RNU后UTUC患者早期进展的重要预测因素.
- 不管病理发现如何,升高的poCY水平可能需要考虑辅助化疗.
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