Elevated Preoperative Serum CA19‐9 Levels in Patients with Hepatocellular Carcinoma Is Associated with Poor Prognosis after Resection

Chen, Yuling; Chen, Chien‐Hung; Hu, Rey‐Heng; Ho, Ming‐Chih; Jeng, Yung‐Ming

doi:10.1155/2013/380797

Cited by 16 publications

(27 citation statements)

References 30 publications

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“…Moreover, persistently elevated CA19-9 levels had a strong predictive value for a poor prognosis of hepatobiliary malignancy 25–28. Our current data also supported the predictive value of CA19-9 in hepatic carcinoma patients.…”

Section: Discussionsupporting

confidence: 86%

Serum levels of preoperative α-fetoprotein and CA19-9 predict survival of hepatic carcinoma patients after liver transplantation

Wan¹,

Zhang²,

Long³

et al. 2014

European Journal of Gastroenterology &Amp; Hepatology

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ObjectiveThe aim of this study was to assess serum levels of presurgical α-fetoprotein (AFP) and carbohydrate antigen 19-9 (CA19-9) as prognostic markers in patients with hepatic carcinoma after liver transplantation (LT).MethodsA total of 226 patients were recruited for the analysis of serum AFP and CA19-9 levels, on the basis of which the tumor marker type (TMT) was defined and evaluated for prognostic prediction. Overall survival (OS) and relapse-free survival (RFS) were analyzed using Kaplan–Meier curves, and univariate and multivariate Cox models.ResultsOne-year and 5-year OS were 79.0 and 58.0%, respectively, whereas RFS were 70.3 and 62.2%, respectively, in this cohort of patients. There were six variables predicting both OS and RFS, including TMT, tumor size, number of tumor lesions, extrahepatic or vascular invasion, and histopathological grade. Among these, TMT, tumor size, and extrahepatic invasion were all independent predictors of OS and RFS among these patients. Further, on the basis of TMT, novel LT selection criteria for patients with hepatic carcinoma, which supplemented the Milan criteria, were adopted, because the patients within the Milan criteria (n=107) and those exceeding Milan but fulfilling the proposed criteria (n=30) had similar 5-year OS (77.8 vs. 79.3%, P=0.862) and RFS (85.5 vs. 75.1%, P=0.210) rates.ConclusionThe data from this study showed that serum levels of preoperative AFP and CA19-9 were able to predict survival of patients with hepatic carcinoma after LT. This study included novel criteria, adding serum AFP and CA19-9 levels to the selection criteria for LT eligibility of patients, in addition to the Milan criteria.

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Section: Discussionsupporting

confidence: 86%

Serum levels of preoperative α-fetoprotein and CA19-9 predict survival of hepatic carcinoma patients after liver transplantation

Wan¹,

Zhang²,

Long³

et al. 2014

European Journal of Gastroenterology &Amp; Hepatology

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“…Persistently elevated CA19-9 levels had been reported to predict poor prognosis in HCC. Chen et al [9] found that 34.9% (106/304) of patients with HBV-and HCV-related HCC have CA19-9 levels > 27 U/ml.…”

Section: Discussionmentioning

confidence: 99%

“…It is also frequently elevated in patients with combined HCC-cholangiocarcinoma. Elevated preoperative serum CA19-9 levels have been reported to be associated with worse survival in HCC patients who had undergone resection (> 27 U/mL) or liver transplantation (> 100 U/ml) [8][9][10]. However, most of these studies mainly included patients with HCVrelated HCC who underwent resection or transplantation, and the underlying mechanism by which CA19-9 in uences prognosis remains unclear.…”

Section: Introductionmentioning

confidence: 99%

Serum CA19-9 Level is Correlated with Liver Inflammation, Cirrhosis, and Poor Prognosis after Curative Resection in Hepatitis B-related Hepatocellular Carcinoma

Zhang¹,

Wang²,

Yang³

et al. 2020

Preprint

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Background: The relationship between serum carbohydrate antigen 19-9 (CA19-9) and hepatocellular carcinoma (HCC) is unclear. To explore the prognostic value of preoperative CA19-9 in α-fetoprotein (AFP)-positive and -negative HCC with hepatitis B virus (HBV) background (HBV-HCC).Methods: We evaluated HBV-HCC patients who underwent curative resection (Cohort 1). Recurrence-free survival (RFS) and overall survival (OS) were assessed, and the clinicopathological characteristics were compared according to a CA19-9 cutoff of ≥ 39 U/ml. Immunohistochemical staining of CA19-9 in HCC tumor tissue and background liver were quantified in another cohort of 216 patients with resected HCC (Cohort 2). Immunohistochemical staining or serum CA19-9 level was also compared between patients with intrahepatic cholangiocarcinoma (ICC) (Cohort 3).Results: 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) in both AFP-positive and AFP-negative patients. CA19-9 ≥ 39 U/ml was also associated with significantly higher incidence of macrovascular invasion compared with CA19-9 < 39 U/ml (23.0% vs. 7.2%, p=0.002), elevated aminotransferase and aspartate aminotransferase to platelet ratio index, and lower albumin. In contrast, no association was found between CA19-9 and systemic inflammation. 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.Conclusions: CA19-9 ≥ 39 U/ml was associated with lower OS and RFS in both AFP-positive and negative HCC patients. CA19-9 is secreted by the background liver but not by tumor cells. Thus, CA19-9 is a prognostic marker for liver inflammation and cirrhosis in HCC.

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“…(25) Chen YL et al studied and found that in the 106 hepatocellular carcinoma patients with preoperative CA19-9 levels were >27 U/mL. (26) 4(57.1%) cases of Gastric ca. CA 19-9 levels <35 U/ml and 3(42.9%) cases of Gastric ca.…”

Section: Discussionmentioning

confidence: 99%

The importance of CA 19-9 in diagnosis and monitoring of Hepatobiliary and Gastrointestinal malignancies

Ali¹

2018

jmscr

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Elevated Preoperative Serum CA19‐9 Levels in Patients with Hepatocellular Carcinoma Is Associated with Poor Prognosis after Resection

Cited by 16 publications

References 30 publications

Serum levels of preoperative α-fetoprotein and CA19-9 predict survival of hepatic carcinoma patients after liver transplantation

Serum levels of preoperative α-fetoprotein and CA19-9 predict survival of hepatic carcinoma patients after liver transplantation

Serum CA19-9 Level is Correlated with Liver Inflammation, Cirrhosis, and Poor Prognosis after Curative Resection in Hepatitis B-related Hepatocellular Carcinoma

The importance of CA 19-9 in diagnosis and monitoring of Hepatobiliary and Gastrointestinal malignancies

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