Serum CYFRA 21-1 in Biliary Tract Cancers: A Reliable Biomarker for Gallbladder Carcinoma and Intrahepatic Cholangiocarcinoma

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• 作者：Li Huang ; Wei Chen ; Peiwen Liang ; Wenjie Hu…
• 关键词：Biliary tract cancers ; Biomarker ; CYFRA 21 ; 1 ; Diagnosis ; Prognosis
• 刊名：Digestive Diseases and Sciences
• 出版年：2015
• 出版时间：May 2015
• 年：2015
• 卷：60
• 期：5
• 页码：1273-1283
• 全文大小：1,521 KB
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• 作者单位：Li Huang (1)
  Wei Chen (1)
  Peiwen Liang (1)
  Wenjie Hu (1)
  Kunsong Zhang (1)
  Shunli Shen (1)
  Jiancong Chen (1)
  Zhaohui Zhang (1)
  Bin Chen (2)
  Yuyan Han (3)
  Fanyin Meng (4) (5)
  Sharon DeMorrow (4) (5)
  Xiaoyu Yin (1)
  Jiaming Lai (1)
  Lijian Liang (1)
  
  1. Department of Hepatobiliary Surgery, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
  2. Department of Interventional Radiology, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
  3. Department of Medicine, Baylor and Scott and White Digestive Disease Research Center, Texas A&M HSC College of Medicine and Scott and White Hospital, Temple, TX, USA
  4. Division of Research, Central Texas Veterans Health Care System, Temple, TX, USA
  5. Department of Medicine, Scott and White Healthcare and Texas A&M Health Science Center, College of Medicine, Temple, TX, USA
  
• 刊物类别：Medicine
• 刊物主题：Medicine & Public Health
  Gastroenterology
  Hepatology
  Oncology
  Transplant Surgery
  Biochemistry
  
• 出版者：Springer Netherlands
• ISSN：1573-2568

文摘

Background Biliary tract cancers encompass gallbladder carcinoma, and intrahepatic, perihilar and distal cholangiocarcinoma. Upregulated serum CYFRA 21-1 has been reported in intrahepatic cholangiocarcinoma. Aims The present study aimed to explore the clinical significance of serum CYFRA 21-1 in all biliary tract cancer subtypes. Methods Serum CYFRA 21-1, carbohydrate antigen 19-9 and carcinoembryonic antigen were quantitated preoperatively, postoperatively and during follow-up in 134 malignant and 52 benign patients. Receiver operator characteristic curves of biomarkers were analyzed. Level of CYFRA 21-1 was correlated with patients-clinicopathological features and follow-up data. Results CYFRA 21-1 was significantly upregulated in biliary malignancies, and expressional difference existed between these subtypes. Based on the maximal Youden’s index, cutoff values were selected (ng/mL): 2.61 for biliary tract cancers (sensitivity 74.6?% and specificity 84.6?%); 3.27 for intrahepatic cholangiocarcinoma (75.6 and 96.2?%) and gallbladder carcinoma (93.7 and 96.2?%); 2.27 for perihilar cholangiocarcinoma (71.0 and 71.2?%); and 2.61 for distal cholangiocarcinoma (63.3 and 84.6?%). CYFRA 21-1 showed better diagnostic performance than other biomarkers in gallbladder carcinoma and intrahepatic cholangiocarcinoma; its performance was not inferior to that of the combination of these three biomarkers and declined after curative resection and re-elevated when tumor recurred, which was correlated with tumor aggressiveness and TNM stage; it was an independent predictor for 1-year recurrence-free survival and overall survival on multivariate analysis. Conclusion Serum CYFRA 21-1 represents a reliable biomarker for gallbladder carcinoma and intrahepatic cholangiocarcinoma.