Long-term outcomes and prognostic markers in gallbladder cancer

Cui, Xiaoning; Zhu, Sha; Tao, Zhihang; Deng, Xinghao; Wang, Yexiao; Gao, Yuanjing; Liao, Yue; Ma, Wei; Zhang, Yiwen; Ma, Xuelei

doi:10.1097/md.0000000000011396

Cited by 16 publications

(20 citation statements)

References 20 publications

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“…Previous studies have assessed the effect of serum levels of tumor markers (AFP, CEA, CA19-9, CA72-4, TPA and TK), on prognosis of carcinoma gall bladder and found that TK, TPS and CEA were the independent prognostic factors forOS in GBC. [ 15 16 17 ]…”

Section: Discussionmentioning

confidence: 99%

“…Furthermore in one study neutrophil to lymphocyte ratio and CEA were associated with poor OS of GBC patients. [ 16 ] Lee = al assessed CEA and CA 19-9 levels post chemotherapy and found CA 19-9 as the independent and most valuable prognosticator. [ 17 ] Similar findings have been reported by Yu et al , who studied CA 19-9 and CEA as the independent prognostic markers in resectable GBC.…”

Section: Discussionmentioning

confidence: 99%

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Role of carbohydrate antigen 19-9, carcinoembryonic antigen, and carbohydrate antigen 125 as the predictors of resectability and survival in the patients of Carcinoma Gall Bladder

Agrawal¹,

Gupta²,

Gupta³

et al. 2020

J Carcinog

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INTRODUCTION: Carcinoembryonic antigen (CEA) and carbohydrate antigen 19-9 (CA19-9) have been reported in previous studies to assess the prognosis of gall bladder cancer (GBC) individually and in combination. However, the evidence of utility of preoperative CA 19-9, CEA and carbohydrate antigen 125 (CA 125) in determining the resectability and prognosis of GBC is still lacking. In the present study we correlated the serum levels of tumor markers CA 19-9, CEA and CA 125 individually and combined to determine the resectability and prognosis of the GBC. MATERIALS AND METHODS: Seventy one diagnosed patients of GBC between January 2018 and September 2019 were included in the present study. Serum CA 19-9, CEA and CA 125 were determined by chemiluminescence. Receiver operating characteristic (ROC) curve was used to evaluate the role of tumor markers in determining the resectability of GBC. The Kaplan Meier survival curves were made and log rank analysis was performed to assess the prognostic role of tumor markers in terms of overall median survival. RESULTS: All the three tumor markers CA19-9, CEA and CA 125 showed high discriminatory power in determining the resectability with respective area under curve of 0.76, 0.68 and 0.78 as determined by ROC. Median survival in patients with high serum CA 19-9, CA 125 was significantly lower than patients with normal serum CA 19-9, CA 125 whereas no significant difference was observed in case of CEA. CONCLUSION: The present study suggested that CA 19-9, CEA and CA 125 can predict resectability in GBC and raised levels of CA 19-9 and CA 125 can predict poor prognosis in patients with elevated levels.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Role of carbohydrate antigen 19-9, carcinoembryonic antigen, and carbohydrate antigen 125 as the predictors of resectability and survival in the patients of Carcinoma Gall Bladder

Agrawal¹,

Gupta²,

Gupta³

et al. 2020

J Carcinog

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show abstract

“…Also, since the outcome for advanced GBC is poor, the willingness of patients with cancer at stage IV for aggressive therapy is usually wobbly, which may impact the strategic choice for surgery to a large extent. On the other hand, the surveyed sample size was limited; the long-term survival come for GBC could be affected by composite factors [6,30,31].…”

Section: Discussionmentioning

confidence: 99%

Impact of surgical strategies on the survival of gallbladder cancer patients: analysis of 715 cases

Chang

et al. 2020

World J Surg Onc

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Objective: The aim of the study is to evaluate the impact of application of surgical strategies at different cancer stages on the survival of gallbladder cancer (GBC) patients. Methods: The patients with GBC were divided into 3 groups according to their received surgical strategies: simple resection (full-thickness cholecystectomy for removal of primary tumor site), radical resection (gallbladder bed removal combined with partial hepatectomy), and palliative surgery (treatment at advanced stages). The overall survival (OS) of GBC patients who were received different surgical strategies was compared. Results: Survival analysis showed that radical resection had a best OS at clinical stage II, and simple resection had a best OS at tumor clinical stage IV. Cox hazard proportional regression analysis showed that more advanced tumor stages, tumor location of gallbladder body or neck, and CA199 ≥ 27 U/mL were the major risk factors for the OS of GBC. Conclusions: At tumor stage II, radical resection should be the most effective surgical therapy for GBC. However, the effect of radical resection at advanced stages could be restricted. The utilization of radical resection should be increased at tumor stage II for a better long-term survival outcome.

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“…Cox proportional hazards model was used for multivariate analysis. The factors identified as significant in univariate analysis were included for the multivariate Cox analysis ( 37 ). Hazard ratios (HRs) were shown as relative risks, with corresponding 95% confidence intervals (CIs).…”

Section: Methodsmentioning

confidence: 99%

GLI2 but not GLI1/GLI3 plays a central role in the induction of malignant phenotype of gallbladder cancer

et al. 2021

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We previously reported that Hedgehog (Hh) signal was enhanced in gallbladder cancer (GBC) and was involved in the induction of malignant phenotype of GBC. In recent years, therapeutics that target Hh signaling have focused on molecules downstream of smoothened (SMO). The three transcription factors in the Hh signal pathway, glioma-associated oncogene homolog 1 (GLI1), GLI2, and GLI3, function downstream of SMO, but their biological role in GBC remains unclear. In the present study, the biological significance of GLI1, GLI2, and GLI3 were analyzed with the aim of developing novel treatments for GBC. It was revealed that GLI2, but not GLI1 or GLI3, was involved in the cell cycle-mediated proliferative capacity in GBC and that GLI2, but not GLI1 or GLI3, was involved in the enhanced invasive capacity through epithelial-mesenchymal transition. Further analyses revealed that GLI2 may function in mediating gemcitabine sensitivity and that GLI2 was involved in the promotion of fibrosis in a mouse xenograft model. Immunohistochemical staining of 66 surgically resected GBC tissues revealed that GLI2-high expression patients had fewer numbers of CD3 + and CD8 + tumor-infiltrating lymphocytes (TILs) and increased programmed cell death ligand 1 (PD-L1) expression in cancer cells. These results suggest that GLI2, but not GLI1 or GLI3, is involved in proliferation, invasion, fibrosis, PD-L1 expression, and TILs in GBC and could be a novel therapeutic target. The results of this study provide a significant contribution to the development of a new treatment for refractory GBC, which has few therapeutic options.

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Long-term outcomes and prognostic markers in gallbladder cancer

Cited by 16 publications

References 20 publications

Role of carbohydrate antigen 19-9, carcinoembryonic antigen, and carbohydrate antigen 125 as the predictors of resectability and survival in the patients of Carcinoma Gall Bladder

Role of carbohydrate antigen 19-9, carcinoembryonic antigen, and carbohydrate antigen 125 as the predictors of resectability and survival in the patients of Carcinoma Gall Bladder

Impact of surgical strategies on the survival of gallbladder cancer patients: analysis of 715 cases

GLI2 but not GLI1/GLI3 plays a central role in the induction of malignant phenotype of gallbladder cancer

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