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- Title
Raised CA19-9 and CEA have prognostic relevance in gallbladder carcinoma.
- Authors
Sachan, Ashish; Saluja, Sundeep Singh; Nekarakanti, Phani Kumar; Nimisha; Mahajan, Bhawna; Nag, Hirdaya H.; Mishra, Pramod K.
- Abstract
<bold>Background: </bold>Role of tumor markers in gall bladder carcinoma (GBC) is not well established. We evaluated the prognostic value of carbohydrate antigen 19-9 (CA19-9) and carcinoma embryonic antigen (CEA) in patients with GBC.<bold>Methods: </bold>Of the 225 patients of GBC enrolled,176 patients were included in the study (excluded 49 patients with jaundice). Patients were divided into 3 groups; resectable n = 92, unresectable n = 17, metastatic n = 67. The clinico-pathological characteristics, tumor markers and survival data were analysed. The cutoff values of CA19-9 & CEA for predicting metastases were computed using receiver operating characteristic curve. Kaplan Meir survival and Cox regression analysis were done for factors predicting survival and recurrence.<bold>Results: </bold>The median value of Ca19-9 was significantly higher in metastatic group [resectable: 21.3, unresectable: 53.9 and metastatic: 79; p < 0.001] but not for CEA [3.5, 7.8 and 5 ng/ml (p = 0.20)]. A cutoff value of 72 IU/ml for CA19-9, 5 ng/ml for CEA had a sensitivity and specificity of 52 and 80%, 51 and 72% respectively for detection of metastatic disease. Median, 3-year & 5-year survival were significantly lower in patients with CEA > 4 (p = 0.041), Ca19.9 > 37 (p = 0.019), T3/T4 (p = 0.001), node positive (p = 0.001) and presence of perineural invasion (p = 0.001). However, on multivariate analysis, only Ca19.9 > 37 predicted recurrence (p = 0.002, HR 5.8).<bold>Conclusions: </bold>Raised CA19.9 and CEA predict metastatic disease in patients with GBC without jaundice with a high specificity and may help in prognostication of the patient. CA19-9 was better than CEA in prediction of tumor burden and in predicting recurrence.
- Subjects
GALLBLADDER cancer; RECEIVER operating characteristic curves; GALLBLADDER; TUMOR markers
- Publication
BMC Cancer, 2020, Vol 20, Issue 1, pN.PAG
- ISSN
1471-2407
- Publication type
journal article
- DOI
10.1186/s12885-020-07334-x