Prognostic significance of carbohydrate antigen 19-9 (CA19-9) change during immediate postoperative periods in patients with stage I-III colorectal cancer.

IF 2.2 Q2 GASTROENTEROLOGY & HEPATOLOGY

Annals of Coloproctology Pub Date : 2025-10-01 Epub Date: 2025-10-23 DOI:10.3393/ac.2025.00528.0075

Wooram Choi, Yongjung Park, Jeonghyun Kang

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引用次数: 0

Abstract

Purpose: Although carbohydrate antigen 19-9 (CA19-9) may exhibit low sensitivity in tumor screening, its prognostic significance has been highlighted. This study assessed the significance of preoperative CA19-9 and early postoperative CA19-9 levels in patients with nonmetastatic colorectal cancer (CRC).

Methods: Patients diagnosed with stage I-III CRC between January 2004 and April 2014 were included. Preoperative CA19-9 was assessed within 2 months of operation, whereas postoperative CA19-9 was measured 4 to 7 days after operation. The optimal cutoff values for preoperative and postoperative CA19-9 were established to maximize the differences in overall survival. Patients were categorized into 3 groups based on the CA19-9 change (CA19-9 trend): group 1, low preoperative CA19-9; group 2, high preoperative and low postoperative CA19-9; and group 3, high preoperative and postoperative CA19-9. The discriminatory powers of all variables were compared using the concordance index.

Results: A total of 816 patients were included. The determined cutoff values for preoperative and postoperative CA19-9 were 18.9 and 21.4 U/mL, respectively. Subgroup dichotomization revealed associations of preoperative CA19-9, postoperative CA19-9, and CA19-9 trend with overall survival in univariable analysis. The CA19-9 trend emerged as an independent prognostic factor in the multivariable analysis (group 1 vs. group 2: hazard ratio, 1.682 [95% confidence interval (CI), 1.043-2.710], P=0.032; group 1 vs. group 3: hazard ratio, 2.882 [95% CI, 1.899-4.371], P<0.001). The concordance index value of the CA19-9 trend (0.636; 95% CI, 0.509-0.682) surpassed those of preoperative and postoperative CA19-9.

Conclusion: The amalgamation of preoperative and postoperative CA19-9 levels demonstrated enhanced prognostic stratification, allowing for a more detailed classification of patients with nonmetastatic CRC.

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I-III期结直肠癌患者术后即刻碳水化合物抗原19-9 （CA19-9）变化的预后意义

目的：虽然碳水化合物抗原19-9 （CA19-9）在肿瘤筛查中敏感性较低，但其预后意义已被强调。本研究评估了术前和术后早期CA19-9水平在非转移性结直肠癌（CRC）患者中的意义。方法：纳入2004年1月至2014年4月诊断为I-III期CRC的患者。术前CA19-9在手术2个月内评估，术后CA19-9在术后4 - 7天测量。建立术前和术后CA19-9的最佳临界值，以最大限度地提高总生存期的差异。根据CA19-9变化（CA19-9趋势）将患者分为3组：1组，术前低CA19-9；2组术前高术后低CA19-9；3组术前术后CA19-9较高。采用一致性指数比较各变量的辨别力。结果：共纳入816例患者。术前和术后CA19-9的临界值分别为18.9和21.4 U/mL。单变量分析显示，术前CA19-9、术后CA19-9和CA19-9趋势与总生存率相关。在多变量分析中，CA19-9趋势成为独立的预后因素(1组vs. 2组：风险比1.682[95%可信区间（CI）， 1.043-2.710]， P=0.032；1组与3组：风险比为2.882 [95% CI, 1.899-4.371]，结论：术前和术后CA19-9水平的合并显示预后分层增强，允许更详细的非转移性结直肠癌患者分类。

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来源期刊

Annals of Coloproctology Multiple-

CiteScore

3.30

自引率

3.20%

发文量