Influence of serum alpha-fetoprotein and CA19-9 on the prognosis of patients with combined hepatocellular-cholangiocarcinoma after radical surgery
10.3760/cma.j.cn113884-20241101-00325
- VernacularTitle:血清甲胎蛋白和CA19-9对混合型肝癌根治术预后的影响
- Author:
Hongjian ZHANG
1
;
Xiaohui DUAN
;
Heng ZHANG
;
Jianpei XUYANG
;
Yuhao QING
;
Zicheng WANG
;
Xianhai MAO
Author Information
1. 邵阳市中心医院（南华大学附属邵阳医院）肝胆外科，邵阳 422000
- Publication Type:Journal Article
- Keywords:
Liver neoplasms;
Alpha-fetoproteins;
Influencing factor;
Prognosis;
Combined hepatocellular-cholangiocarcinoma
- From:
Chinese Journal of Hepatobiliary Surgery
2025;31(2):87-91
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To analyze the impact of serum alpha-fetoprotein (AFP) and carbohydrate antigen 19-9 (CA19-9) on the prognosis of patients with combined hepatocellular-cholangiocarcinoma (CHC) after radical surgery.Methods:Clinical data of 100 patients diagnosed with CHC by postoperative pathology in Hunan Provincial People's Hospital from January 2009 to January 2019 were retrospectively analyzed, including 73 males and 27 females, aged (52.0±10.9) years. Univariate and multivariate Cox regression analysis were conducted to try to find out the effects of AFP and CA19-9 on postoperative disease-free survival (DFS) of patients with CHC. Subgroup analysis was also performed to analyze the DFS among patients with different levels of AFP and CA19-9. Kaplan-Meier method and log-rank test were used to plot and compare the survival curves between groups.Results:Univariate analysis showed that levels of AFP, CA19-9, alanine transaminase, aspartate transaminase, American Joint Committee on Cancer (AJCC) TNM staging, portal vein invasion, tumor number are associated with postoperative DFS in CHC patients (all P<0.05). The multivariate Cox analysis showed that AFP≥20.6 μg/L ( HR=6.686, 95% CI: 1.985-9.582), CA19-9≥35.2 U/L ( HR=5.790, 95% CI: 1.197-8.855), AJCC tumor TNM staging stage Ⅱ( HR=6.384, 95% CI: 2.069-11.532), and portal vein invasion ( HR=2.384, 95% CI: 1.100-10.125) were risk factors for a shortened DFS in CHC patients after surgery (all P<0.05). Subgroup analysis showed that patients with AFP≥20.6 μg/L and CA19-9≥35.2 U/L ( n=14) had a lower DFS compared to patients with AFP<20.6 μg/L and CA19-9≥35.2 U/L ( n=32), and patients with AFP≥20.6 μg/L and CA19-9<35.2 U/L ( n=20) ( χ2=6.23, 4.98, P=0.014, 0.043). Conclusion:AFP and CA19-9 are risk factors for DFS in CHC patients. Patients with AFP≥20.6 μg/L and CA19-9≥35.2 U/L showed a worse prognosis.
