Clinical significance of joint application of carcinoembryionic and carbohydrate antigen 19-9 for improving the prognostic prediction in patients with gallbladder cancer

Abstract

Objective To investigate the clinical significance of joint application of carcinoembryionic and carbohydrate antigen 19-9 for improving the prognosis of patients with gallbladder cancer. Methods A retrospective analysis of clinical-pathological features and prognosis were conducted including 390 patients with gallbladder cancer, who were treated from January 2003 to December 2013 at Eastern Hepatobiliary Surgery Hospital of Second Military Medical University. The clinical value of joint application of carcinoembryionic and carbohydrate antigen 19-9 in prognosis was explored. The survival of patients was followed up by telephone or outpatient.Continuous variables were indicated as median (average) and categorical variables were expressed as number(n). Mann-Whitney U test was applied for continuous variables. Categorical variables were compared by the Chi-square test or Fisher probability method. The survival curve was drawn by the Kaplan-Meier method. The univariate analysis and multivariate analysis of prognosis were respectively done using the Log-rank test and COX regression model. Results Of the 390 patients, 327 had complete data. The median (range) follow-up time was 49 (1-123) months. Both carcinoembryionic and carbohydrate antigen 19-9 could be used to predict prognosis of gallbladder cancer. A linear combination of carcinoembryionic and carbohydrate antigen 19-9 was significantly better(0.9365) than carbohydrate antigen 19-9(0.7619) as well as carcinoembryionic(0.7937) alone in term of specificity. Preoperative blood test carcinoembryionic and carbohydrate antigen 19-9 nature showed double-negative group had the best prognosis, with a median survival of 27.06 months, R0 radical rate was 86.1%. Double-positive group had the worst prognosis, with a median survival of 6.17 months, R0 radical rate was 45.1%. Conclusions Combinations of pretherapeutic tumor makers carcinoembryionic and carbohydrate antigen 19-9 can improve the accuracy of predicting prognostic in patients with gallbladder cancer, and the clinical application is practical. Key words: Gallbladder neoplasms; Tumor markers, biological; Carcinoembryionic antigen; Carbohydrate antigen 19-9; Prognosis