肝内胆管细胞癌患者血清CEA、CA125、CYFRA21-1和VEGF水平判断预后价值研究*

doi:10.3969/j.issn.1672-5069.2025.03.031

摘要/Abstract

摘要： 目的探讨肝内胆管细胞癌(ICC)患者血清癌胚抗原(CEA)、糖类抗原125(CA125)、细胞角蛋白片段抗原(CYFRA)21-1和血管内皮生长因子(VEGF)水平变化,分析血清指标评估ICC患者预后的价值。方法 2020年2月～2023年2月我院收治的ICC患者81例,均接受GEMOX化疗联合卡瑞丽珠单抗方案治疗,21 d为一个周期,持续治疗4个周期。采用电化学发光法检测血清CEA、CA125、CYFRA21-1和VEGF水平。应用多因素Cox回归模型分析影响ICC患者预后的危险因素。结果 26例多发肿瘤的ICC患者血清CEA、CA125、CYFRA21-1和VEGF水平分别为(18.9±3.4)ng/mL、(110.3±9.5)ng/mL、(22.1±3.8)U/mL和(268.8±12.6)pg/mL,均显著高于55例单发肿瘤患者【分别为(11.8±3.3)ng/mL、(66.8±18.0)ng/mL、(10.8±3.7)U/mL和(199.6±37.1)pg/mL,P＜0.05】,52例有淋巴结转移患者血清CEA、CA125、CYFRA21-1和VEGF水平分别为(16.5±3.4)ng/mL、(93.7±23.1)ng/mL、(17.6±5.6)U/mL和(249.6±24.5)pg/mL,均显著高于29例无淋巴结转移患者分别为【(10.4±3.6)ng/mL、(59.6±14.8)ng/mL、(9.1±3.7)U/mL和(173.6±29.5)pg/mL,P＜0.05】,38例肿瘤直径大于5 cm患者血清CEA、CA125、CYFRA21-1和VEGF水平分别为(17.5±4.2)ng/mL、(106.5±11.0)ng/mL、(19.0±5.8)U/mL和259.8±17.9)pg/mL,均显著高于43例肿瘤直径小于5 cm患者【分别为(11.2±3.1)ng/mL、(58.5±9.7)ng/mL、(10.4±3.8)U/mL和(187.9±33.6)pg/mL,P＜0.05】,39例TNM Ⅳ期患者血清CEA、CA125、CYFRA21-1和VEGF水平分别为(17.5±4.2)ng/mL、(105.5±12.1)ng/mL、(18.8±5.8)U/mL和(258.1±20.6)pg/mL,均显著高于42例Ⅱ/Ⅲ期患者【分别为(11.1±3.0)ng/mL、(58.1±9.5)ng/mL、(10.4±3.8)U/mL和(187.8±34.0)pg/mL,P＜0.05】;81例ICC患者1a生存率为71.6%;多因素Cox回归模型分析结果显示,TNMⅢ/Ⅳ期、高水平CEA、CA125和VEGF为影响ICC患者预后的独立危险因素(P＜0.05)。结论血清CEA、CA125、CYFRA21-1和VEGF水平评估接受化疗治疗的ICC患者近期疗效和预后具有一定的临床价值。

关键词: 肝内胆管细胞, 癌胚抗原, 糖类抗原125, 细胞角蛋白片段抗原, 血管内皮生长因子, 预后

Abstract: Objective The aim of this study was to explore implication of serum carcinoembryonic antigen (CEA), carbohydrate antigen 125 (CA125), cytokeratin fragment antigen( CYFRA ) 21-1 and vascular endothelial growth factor (VEGF) level changes in patients with intrahepatic cholangiocarcinoma (ICC). Methods 81 patients with ICC were admitted to our hospital between February 2020 and February 2023, and all received GEMOX chemotherapy and carelizumab treatment for 4 cycles with one cycle of 21 days. Serum CEA, CA125, CYFRA21-1 and VEGF levels were routinely detected by electrochemiluminescence immunoassay. The influencing factors of prognosis in ICC patients were analyzed by multivariate Cox regression model. Results Serum CEA, CA125, CYFRA21-1 and VEGF levels in 26 patients with multiple ICC were (18.9±3.4)ng/mL, (110.3±9.5)ng/mL, (22.1±3.8)U/mL and (268.8±12.6)pg/mL, all significantly higher than [(11.8±3.3)ng/mL, (66.8±18.0)ng/mL, (10.8±3.7)U/mL and (199.6±37.1)pg/mL, respectively, P＜0.05] in 55 patients with single ICC, serum CEA, CA125, CYFRA21-1 and VEGF levels in 52 ICC patients with lymph node metastasis were (16.5±3.4)ng/mL, (93.7±23.1)ng/mL, (17.6±5.6)U/mL and (249.6±24.5)pg/mL, all significantly higher than [[(10.4±3.6)ng/mL, (59.6±14.8)ng/mL, (9.1±3.7)U/mL and (173.6±29.5)pg/mL, respectively, P＜0.05] in 29 ICC patients without lymph node metastasis, serum CEA, CA125, CYFRA21-1 and VEGF levels in 38 patients with tumor diameter greater than 5 cm were (17.5±4.2)ng/mL, (106.5±11.0)ng/mL, (19.0±5.8)U/mL and 259.8±17.9)pg/mL, all significantly higher than [(11.2±3.1)ng/mL, (58.5±9.7)ng/mL, (10.4±3.8)U/mL and (187.9±33.6)pg/mL, respectively, P＜0.05] in 43 patients with tumor less than 5 cm, serum CEA, CA125, CYFRA21-1 and VEGF levels in 39 patients with TNM phase Ⅳ were(17.5±4.2)ng/mL, (105.5±12.1)ng/mL, (18.8±5.8)U/mL and (258.1±20.6)pg/mL, all significantly higher than [(11.1±3.0)ng/mL, (58.1±9.5)ng/mL, (10.4±3.8)U/mL and (187.8±34.0)pg/mL, respectively, P＜0.05] in 42 patients with phase Ⅱ/Ⅲ; one-year survival in 81 patients with ICC in our series was 71.6%, and multivariate Cox regression analysis showed that TNMphase Ⅲ/Ⅳ, high serum CEA, CA125 and VEGF levels were all the independent risk factors impacting prognosis of patients with ICC (P＜0.05). Conclusion High serum CEA, CA125, CYFRA21-1 and VEGF levels in patients with ICC might be related to poor prognosis, which warrants further clinical investigation.

Key words: Intrahepatic cholangiocarcinoma, Carcinoembryonic antigen, Carbohydrate antigen 125, Cytokeratin fragment antigen 21-1, Vascular endothelial growth factor, Prognosis

黄燕, 杨志勇, 黄骞, 梁洪享. 肝内胆管细胞癌患者血清CEA、CA125、CYFRA21-1和VEGF水平判断预后价值研究^*[J]. 实用肝脏病杂志, 2025, 28(3): 442-445.

Huang Yan, Yang Zhiyong, Huang Qian, et al. Poor prognosis of patients with intrahepatic cholangiocarcinoma with high serum CEA, CA125, CYFRA21-1 and VEGF levels[J]. Journal of Practical Hepatology, 2025, 28(3): 442-445.

参考文献

[1] 孙岩,张鑫,李国宾,等.接受根治性肝切除术治疗的肝内胆管细胞癌患者肿瘤组织成纤维细胞生长因子受体2表达及其临床意义探讨.实用肝脏病杂志,2023,26(6):907-910.
[2] Argemi J, Ponz-Sarvise M, Sangro B. Immunotherapies for hepatocellular carcinoma andintrahepatic cholangiocarcinoma: Current and developing strategies. Adv Cancer Res, 2022,156:367-413.
[3] Li Y, Yu J, Zhang Y, et al. Advances in targeted therapy of cholangiocarcinoma. Ann Med, 2024, 56(1):2310196.
[4] Yan W, Li Y, Peng Z. Clinical value of combined detection of carcinoembryonic antigen and CA125 in the diagnosis of non-small cell lung cancer combined with malignant pleural effusion. Pak J Med Sci, 2024, 40(5):995-1000.
[5] He L, Chen X, Ding L, et al. Clinical efficacy of antianlotinib combined with immune checkpoint inhibitors in the treatment of advanced non-small-cell lung cancer and its effect on serum VEGF, CEA, and SCC-Ag. J Oncol, 2022:1530875.
[6] Margoni A, Gargalionis AN, Papavassiliou AG. CA-125:CA72-4 ratio - towards a promising cost-effective tool in ovarian cancer diagnosis and monitoring of post-menopausal women underhormone treatment. J Ovarian Res, 2024, 17(1):164.
[7] Kinzler MN, Schulze F, Gretser S, et al. Expression of MUC16/CA125 is associated with impaired survival in patients with surgical resected cholangiocarcinoma. Cancers (Basel), 2022, 14(19):4703.
[8] Zhang N,Li Y, Sun Z, et al. Combined detection of SHOX2 and PTGER4 methylation with serum marker CYFRA21-1 for improved diagnosis of malignant pleural mesothelioma. J Clin Pathol, 2024, 26:209592.
[9] Liu J, Du Q, Shao Y, et al. Real-world status, efficacy and prognosis analysis of first-line treatment for unresectable hepatocellular carcinoma in patients treated at multiple centres. Ann Med, 2024, 56(1):2393291.
[10] 杨甲梅. 实用肝胆外科学. 上海:上海人民出版社, 2009:122-126.
[11] 汤朝晖,唐陈伟,王寿华,等.肝内胆管癌侵袭转移机制的研究现状与进展.中华消化外科杂志,2019,18(4):321-327.
[12] Weng G, Fang W, Lin Y, et al. Clinical effect of anlotinib in combination with docetaxel in treating advanced non-small cell lung cancer. Cell Mol Biol (Noisy-le-grand), 2024, 70(4):212-216.
[13] Jin B, Wen X, Tian H, et al. Standardized uptake valuemax of theprimary lesion combined with tumor markers for clinical predicting distant metastasis in de novo lung adenocarcinoma. Cancer Med, 2024, 13(7):e6961.
[14] Ediz C, Terzi NK, Akan S, et al. Association between serum carcino-embryonic antigen levels and micropapillary bladder cancer metastasis in an elderly male. J Coll Physicians Surg Pak, 2022, 32(8):S186-S188.
[15] Xu F, Cai Z, Xu B, et al. Clinical research on the combined use of systemic chemotherapy and CT-guided radiofrequency ablation in treatment of lung cancer. Lasers Med Sci, 2022, 37(1):233-239.
[16] 马伟虎,雷正清,余秋石,等.肝内胆管癌淋巴结转移个体化术前预测模型的构建及应用.中华外科杂志,2022,60(4):363-371.
[17] Lin H, Zhong W, Zhong L, et al. The inflammatory markers combined with CA125 may predict postoperative survival in endometrial cancer. J Obstet Gynaecol, 2024, 44(1):2373937.
[18] 赛亚飞,高美丽,金发光,等. 血清肿瘤标志物CEA、CA125、CYFRA21-1在支气管肺癌诊断、病理类型及TNM分期中的价值分析. 中华肺部疾病杂志(电子版),2019,12(1):34-37.
[19] Capuozzo M, Santorsola M, Ferrara F, et al. Intrahepatic cholangiocarcinoma biomarkers: Towards early detection and personalized pharmacological treatments. Mol Cell Probes, 2024, 73:101951.
[20] Brown ZJ, Hewitt DB, Pawlik TM. Biomarkers of intrahepatic cholangiocarcinoma: diagnosis and response to therapy. Front Biosci (Landmark Ed), 2022, 27(3):85.
[21] Romanzi A, Milosa F, Marcelli G, et al. Angiopoietin-2 and the vascular endothelial growth factor promote migration and invasion in hepatocellular carcinoma- and intrahepatic cholangiocarcinoma-derived spheroids. Biomedicines, 2023, 12(1):87.
[22] Peng M, Li H, Cao H, et al. Dual FGFR and VEGFR inhibition synergistically restrain hexokinase 2-dependent lymphangiogenesis and immune escape in intrahepatic cholangiocarcinoma. J Gastroenterol, 2023, 58(9):908-924.

肝内胆管细胞癌患者血清CEA、CA125、CYFRA21-1和VEGF水平判断预后价值研究^*

Poor prognosis of patients with intrahepatic cholangiocarcinoma with high serum CEA, CA125, CYFRA21-1 and VEGF levels

PDF (PC)

可视化

摘要/Abstract

引用本文

使用本文

参考文献

相关文章 15

编辑推荐

Metrics

本文评价

[1]	郭建晖, 周永兵, 何钦. 慢加急性乙型肝炎肝衰竭患者血清sST2、TLR4、suPAR和Beclin1水平变化及其临床意义探讨^*[J]. 实用肝脏病杂志, 2025, 28(2): 230-233.
[2]	李士伟, 李家国, 诸靖, 张颖洁. 乙型肝炎相关慢加急性肝衰竭患者血清ANGPTL2、sVAP-1和HMGB1水平变化及其预测预后的价值研究^*[J]. 实用肝脏病杂志, 2025, 28(2): 234-237.
[3]	何培, 冯磊, 曹向红, 王佳, 彭传梅, 孔凡斌, 陶春晖, 张振华. RNA m6A甲基化与肝细胞癌的相关性及对肝癌患者预后作用的Meta分析^*[J]. 实用肝脏病杂志, 2025, 28(2): 254-257.
[4]	钟新梅, 闫莉莉, 张冬梅. 细菌性肝脓肿患者临床特征与病原菌分析^*[J]. 实用肝脏病杂志, 2025, 28(2): 286-289.
[5]	封顺, 赵磊, 张丽娟. 慢加急性肝衰竭患者血清人β防御素-1、高尔基体蛋白73和白介素-33水平变化及其临床意义探讨^*[J]. 实用肝脏病杂志, 2025, 28(1): 80-83.
[6]	孙敏, 张倩, 徐刚, 王加林, 何振文. ACLF患者肺部感染发生率及预测因素分析^*[J]. 实用肝脏病杂志, 2025, 28(1): 84-87.
[7]	许文慧, 许箐贇, 李彬彬, 潘超. 间接测热法与公式法测定失代偿期乙型肝炎肝硬化患者静息能量消耗临床意义探讨^*[J]. 实用肝脏病杂志, 2025, 28(1): 116-119.
[8]	牛日雨, 王益杰, 王欣, 李成忠. 基于癌症基因组图谱数据库双硫死亡相关LncRNA构建肝细胞癌预后模型及其效能分析[J]. 实用肝脏病杂志, 2025, 28(1): 128-131.
[9]	杨爽, 高学松, 段雪飞. 难治性原发性胆汁性胆管炎研究进展^*[J]. 实用肝脏病杂志, 2025, 28(1): 156-159.
[10]	李靖, 何海滨, 李春婷, 石磊. 230例药物性肝损伤患者临床特征分析^*[J]. 实用肝脏病杂志, 2024, 27(6): 870-873.
[11]	徐曼曼, 杨颜榕, 李珊珊, 武羽, 杨雪, 段钟平, 陈煜. 我院近10年肝衰竭患者预后变化趋势分析^*[J]. 实用肝脏病杂志, 2024, 27(6): 874-877.
[12]	丘仲琼, 林建辉, 翁钘钘, 陈丽霞, 刘海钰. 影响慢加急性乙型肝炎肝衰竭并发医院获得性肺炎患者预后危险因素分析^*[J]. 实用肝脏病杂志, 2024, 27(6): 878-881.
[13]	董旭, 秦阳华, 廖威, 许明晓, 葛玲玲, 李成忠. 乙型肝炎肝硬化和慢加急性肝衰竭患者并发感染影响因素与预后分析^*[J]. 实用肝脏病杂志, 2024, 27(6): 891-894.
[14]	曾旺, 蔡晓曼, 葛尚. 肝内胆管细胞癌与肝细胞癌病灶MRI增强扫描表现差异分析^*[J]. 实用肝脏病杂志, 2024, 27(6): 907-910.
[15]	张怀东, 雷宇, 周智. 失代偿期肝硬化合并肝外脓肿患者临床特点分析[J]. 实用肝脏病杂志, 2024, 27(5): 761-764.