Abstract: The predictive value of preoperative serum CA19-9 combined with CA125 for the prognosis of patients with intrahepatic cholangiocarcinoma        ZHAO Ying*, LIAO Bing, CHEN Wei, et al. *Department of Pancreato-Biliary Surgery, the First Affiliated Hospital of Sun Yat-sen University, Guangzhou 510080, China
Corresponding author: CHEN Dong, E-mail: gzbobsums2004@126.com ; YIN Xiao-yu, E-mail: yinxy@mail.sysu.edu.cn
Abstract    Objective    To assess the value of preoperative serum CA19-9 combined with CA125 in evaluating the survival among intrahepatic cholangiocarcinoma (ICC) patients who underwent radical resection. Methods    Retrospective analysis was performed on the clinicopathological and follow-up data of 145 patients who underwent curative-intent resection in the First Affiliated Hospital, Sun Yat-sen University and were pathologically confirmed as ICC from February 2013 to August 2019. Independent prognostic risk factors were analyzed by using Kaplan-Meier method, univariate and multivariate Cox proportional risk models. Chi-square test was used to compare the clinical characteristics of ICC patients with different levels of CA19-9 and CA125. Results    Univariate and multivariate analysis suggested that both CA19-9 and CA125 were independent risk factors for the survival of ICC patients underwent radical resection (P=0.032, P=0.029). The prognosis of patients in the CA19-9(+)/CA125(+)group was significantly lower when compared with the CA19-9(-)/CA125(-)or CA19-9(+)/CA125(-)groups, respectively (P<0.001, P=0.008). And regardless of in the CA19-9(+) or CA19-9(-) group, patients with CA125(+) were in a more advanced tumor TNM stage (P=0.023，P=0.005). 
Conclusion    Combination of preoperative serum CA19-9 and CA125 level can better predict the prognosis of ICC patients by the fact that CA125 positive ICC patients are in more advanced TNM stage.

Key words: intrahepatic cholangiocarcinoma, carbohydrate antigen 19-9, carbohydrate antigen 125, prognosis

摘要： 目的    评估术前血清CA19-9联合CA125水平对肝内胆管癌（ICC）根治术后病人预后的预测价值。
方法    回顾性分析2013年2月至2019年8月在中山大学附属第一医院行根治性手术切除，且术后病理学检查确诊为ICC的145例病人的临床病理及随访资料。采用Kaplan-Meier法，单因素和多因素COX比例风险模型分析预后相关的独立危险因素。比较不同CA19-9、CA125水平ICC病人的临床特征。 结果    单因素及多因素分析提示术前血清CA19-9及CA125水平都是ICC预后的独立危险因素（P=0.032，P=0.029）。根据术前CA19-9和CA125是否为阳性［CA19-9>37 kU/L为CA19-9（＋），CA19-9≤37 kU/L为CA19-9（-），CA125>35 kU/L为CA125（＋），CA125≤35 kU/L为CA125（-）］分组结果显示：CA19-9（+）/CA125（+）组病人预后明显低于CA19-9（-）/CA125（-）或CA19-9（+）/CA125（-）组（P<0.001，P=0.008）。不论 CA19-9（+）或CA19-9（-），CA125（+）病人肿瘤TNM分期较差（P=0.023，P=0.005）。结论    术前血清CA19-9联合CA125水平可更好的预测ICC病人的预后，原因可能与术前血清CA125阳性ICC病人TNM分期处于更晚期有关。

关键词: 肝内胆管癌, 糖类抗原19-9, 糖类抗原125, 预后