血清 CA19-9 升高表明乙型肝炎相关肝细胞癌根治性切除术后严

StephenW

血清 CA19-9 升高表明乙型肝炎相关肝细胞癌根治性切除术后严重的肝脏炎症和较差的生存率
张伟1、王莹颖1、向东12、博洋3、周宏远1、陆臣1、张泽武1、秦张1、曹广泰1、韩志强1、李慧凯1、崔云龙1、强吴 1 , 张体 1 , 田强松 1 , 李强 1
隶属关系
隶属关系

    1
    天津医科大学肿瘤医院肝胆外科；天津医科大学肿瘤研究所和医院肝癌中心；国家癌症临床研究中心；天津市肿瘤防治重点实验室；天津市癌症临床研究中心，天津，中国。
    2
    中国河北省沧州市，河北沧州中西医结合医院普外科。
    3
    天津医科大学肿瘤医院病理科；天津医科大学肿瘤研究所和医院肝癌中心；国家癌症临床研究中心；天津市肿瘤防治重点实验室；天津市癌症临床研究中心，天津，中国。

    PMID：34880159 DOI：10.5582/bst.2021.01517

抽象的

我们探讨了术前 CA19-9 在乙型肝炎病毒 (HBV) 背景 (HBV-HCC) 的甲胎蛋白 (AFP) 阳性和阴性 HCC (HBV-HCC) 中的预后价值，并探讨了其潜在机制。在接受根治性切除的 HBV-HCC 患者（队列 1）中评估了无复发生存期（RFS）和总生存期（OS）。在另一组 216 名切除的 HCC 患者（组 2）中对 HCC 和肝实质中 CA19-9 的免疫组织化学染色进行了量化。还在 HCC 和肝内胆管癌 (ICC) 患者之间比较了 CA19-9 的免疫组织化学染色和血清 CA19-9 水平（队列 3）。在队列 1 中，CA19-9 ≥ 39 U/mL 是 RFS（HR = 1.507，95% CI = 1.087-2.091，p = 0.014）和 OS（HR = 1.646，95% CI = 1.146-2.366）的独立危险因素, p = 0.007)。与 CA19-9 < 39 U/mL（23.0% vs. 7.2%，p = 0.002）相比，CA19-9 ≥ 39 U/mL 还与大血管浸润 (MaVI) 发生率显着升高相关，并且转氨酶和天冬氨酸转氨酶升高血小板比率指数 (APRI) 和较低的白蛋白。 CA19-9 的免疫组织化学染色显示 CA19-9 表达仅在背景肝脏中发现，而不是在 HCC 肿瘤细胞中。相比之下，肿瘤组织是 ICC 患者 CA19-9 的主要来源。 CA19-9 ≥ 39 U/mL 与 AFP 阳性和阴性 HCC 患者较差的 OS 和 RFS 相关。 CA19-9 表明 HCC 患者肝脏中更严重的炎症和肝硬化。

关键词：EpCAM；碳水化合物抗原 19-9；肝细胞癌;生存；甲胎蛋白。

StephenW

Elevated serum CA19-9 indicates severe liver inflammation and worse survival after curative resection in hepatitis B-related hepatocellular carcinoma
Wei Zhang  1 , Yingying Wang  1 , Xiang Dong  1   2 , Bo Yang  3 , Hongyuan Zhou  1 , Lu Chen  1 , Zewu Zhang  1 , Qin Zhang  1 , Guangtai Cao  1 , Zhiqiang Han  1 , Huikai Li  1 , Yunlong Cui  1 , Qiang Wu  1 , Ti Zhang  1 , Tianqiang Song  1 , Qiang Li  1
Affiliations
Affiliations

    1
    Department of Hepatobiliary Surgery, Tianjin Medical University Cancer Institute and Hospital; Liver Cancer Center, Tianjin Medical University Cancer Institute and Hospital; National Clinical Research Center for Cancer; Key Laboratory of Cancer Prevention and Therapy, Tianjin; Tianjin's Clinical Research Center for Cancer, Tianjin, China.
    2
    Department of Department of General Surgery, Hebei Cangzhou Hospital of Integrated Traditional Chinese and Western Medicine, Cangzhou City, Hebei Province, China.
    3
    Department of Pathology, Tianjin Medical University Cancer Institute and Hospital; Liver Cancer Center, Tianjin Medical University Cancer Institute and Hospital; National Clinical Research Center for Cancer; Key Laboratory of Cancer Prevention and Therapy, Tianjin; Tianjin's Clinical Research Center for Cancer, Tianjin, China.

    PMID: 34880159 DOI: 10.5582/bst.2021.01517

Abstract

We explored the prognostic value of preoperative CA19-9 in α-fetoprotein (AFP)-positive and -negative HCC with hepatitis B virus (HBV) background (HBV-HCC), and explored the underlying mechanism. Recurrence-free survival (RFS) and overall survival (OS) were assessed in HBV-HCC patients who underwent curative resection (Cohort 1). Immunohistochemical staining of CA19-9 in HCC and liver parenchyma were quantified in another cohort of 216 patients with resected HCC (Cohort 2). Immunohistochemical staining of CA19-9 and serum CA19-9 level was also compared between patients with HCC and intrahepatic cholangiocarcinoma (ICC) (Cohort 3). In Cohort 1, CA19-9 ≥ 39 U/mL was an independent risk factor for RFS (HR = 1.507, 95% CI = 1.087-2.091, p = 0.014) and OS (HR = 1.646, 95% CI = 1.146-2.366, p = 0.007). CA19-9 ≥ 39 U/mL was also associated with significantly higher incidence of macrovascular invasion (MaVI) compared with CA19-9 < 39 U/mL (23.0% vs. 7.2%, p = 0.002), and elevated aminotransferase and aspartate aminotransferase to platelet ratio index (APRI), and lower albumin. Immunohistochemical staining of CA19-9 revealed that CA19-9 expression was found exclusively in the background liver but not in HCC tumor cells. In contrast, tumor tissue was the main source of CA19-9 in ICC patients. CA19-9 ≥ 39 U/mL was associated with worse OS and RFS in both AFP-positive and negative HCC patients. CA19-9 indicated more severe inflammation and cirrhosis in the liver of HCC patients.

Keywords: EpCAM; carbohydrate antigen 19-9; hepatocellular carcinoma; survival; α-fetoprotein.

StephenW

https://www.jstage.jst.go.jp/art ... pub_2021.01517/_pdf