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©2014 Baishideng Publishing Group Co.
World J Gastroenterol. Apr 14, 2014; 20(14): 4085-4092
Published online Apr 14, 2014. doi: 10.3748/wjg.v20.i14.4085
Published online Apr 14, 2014. doi: 10.3748/wjg.v20.i14.4085
Table 1 Surgical modalities and their relationship with tumor stage in the gallbladder cancer group
Surgical modality | TNM stage | ||||
II | IIIA | IIIB | IVA | IVB | |
C + N | 6 | 8 | 2 | ||
C + WR + N | 1 | 6 | 4 | ||
C + S4aS5 + N | 1 | 7 | 3 | ||
C + ELH + N | 1 | ||||
C + ERH + N | 1 | ||||
C + BD + N | |||||
C + WR + BD + N | 1 | 6 | 2 | ||
C + S4As5 + BD + N | 4 | 2 | |||
C + CH + BD + N | 3 | 1 | |||
C + S4aS5 + other + N | 1 | 1 | |||
C + S4aS5 + other + N | 5 | ||||
C + ERH + BD + other + N | 1 | 1 | |||
HPD + N | 1 | ||||
Palliative resection | 1 | 2 | |||
Simple drainage | 1 | 3 | |||
Pure exploration | 2 |
Table 2 Comparison of serum cancer antigen 199, cancer antigen 125, cancer antigen 242, and carcinoembryonic antigen levels
Table 3 Positive rates of carcinoembryonic antigen, cancer antigen 125, cancer antigen 242, and cancer antigen 199 n (%)
Table 4 Correlations between gallbladder cancer markers, tumor size, location, and staging
Group | n | MFI (CEA) | MFI (CA199) | MFI (CA125) | MFI (CA242) |
Age (yr) | |||||
≥ 50 | 45 | 9.5 ± 4.3 | 239.1 ± 324.6 | 55.9 ± 86.6 | 39.9 ± 42.9 |
< 50 | 33 | 9.2 ± 2.7 | 236.9 ± 319.4 | 54.6 ± 78.9 | 39.9 ± 47.3 |
Sex | |||||
Male | 30 | 9.3 ± 6.6 | 234.6 ± 356.9 | 54.8 ± 81.7 | 38.5 ± 47.1 |
Female | 48 | 9.4 ± 3.8 | 240.4 ± 298.7 | 55.7 ± 89.5 | 40.8 ± 49.9 |
Tumor position | |||||
Neck | 37 | 8.5 ± 3.9 | 262.2 ± 177.8b | 62.1 ± 47.0b | 42.5 ± 45.9b |
Body | 23 | 5.2 ± 4.2 | 28.3 ± 20.7 | 56.9 ± 99.7 | 19.0 ± 21.6 |
Bottom | 5 | 3.3 ± 2.6 | 27.6 ± 2.4b | 14.5 ± 6.5b | 8.5 ± 2.9b |
Cystic duct | 13 | 21.5 ± 25.1 | 622 ± 196.9 | 49.0 ± 32.9 | 81.7 ± 56.7 |
Staging | |||||
II | 7 | 3.2 ± 2.2 | 66.1 ± 6.3a | 17.7 ± 7.7a | 8.4 ± 3.3a |
IIIA | 10 | 2.0 ± 0.9 | 89.5 ± 8.2 | 47.3 ± 38.2 | 10.2 ± 9.9 |
IIIB | 33 | 6.9 ± 6.4 | 205.5 ± 33.9a | 59.6 ± 114.1a | 22 ± 22.6a |
IVA | 6 | 3.5 ± 3.3 | 383.6 ± 55.5a | 58.1 ± 25.5a | 55.2 ± 25.3a |
IVB | 22 | 19.9 ± 9.1 | 418.7 ± 316.5a | 64.1 ± 50.5a | 86.2 ± 56.9a |
Tumor size | |||||
> 5 cm | 20 | 9.6 ± 2.2 | 768.1 ± 272.9a | 82.9 ± 21.9a | 81.8 ± 53.1a |
≤ 5 cm | 58 | 9.3 ± 1.2 | 55.4 ± 68.7a | 45.8 ± 10.1a | 25.5 ± 32.9a |
Pathological type | |||||
Highly differentiated | 8 | 3.0 ± 2.0 | 68.9 ± 5.9a | 16.7 ± 7.7a | 8.7 ± 3.1a |
Moderately differentiated | 54 | 6.9 ± 5.9 | 142.3 ± 200.4 | 49.9 ± 9.9 | 33.8 ± 41.3 |
Poorly differentiated | 11 | 3.5 ± 2.5 | 649.1 ± 209.1a | 84.0 ± 29.4a | 73.4 ± 58.9a |
Carcinoid | 2 | 20.9 ± 14.6 | 766.3 ± 330.5a | 121.3 ± 45.2a | 62.7 ± 9.4a |
Squamous cell carcinoma | 2 | 107.5 ± 69.1 | 334.4 ± 14.9a | 116.0 ± 103.1a | 108.5 ± 58.7a |
Signet ring cell carcinoma | 1 | 31 | 1000a | 89.3a | 69.3a |
Table 5 Analyses of the sensitivity of tumor markers in different stages of gallbladder cancer n (%)
Table 6 Evaluation of diagnostic value of a single tumor marker in 78 gallbladder cancer cases
Diagnostic value | n | Sensitivity | Specificity | Positive likelihood ratio | Negative likelihood ratio |
CEA | 9 | 11.5% | 97.4% | 4.42 | 0.91 |
CA199 | 56 | 71.7% | 96.1% | 18.4 | 0.29 |
CA242 | 50 | 64.1% | 98.7% | 49.5 | 0.36 |
CA125 | 35 | 44.8% | 96.2% | 11.79 | 0.57 |
Table 7 Analyses of different combinations of markers in gallbladder cancer diagnosis
Group | n | 1 item (+) | 2 item (+) | 3 item (+) | 4 item (+) |
Normal | 78 | 4 (5.1) | 3 (3.8) | 0 (0) | 0 (0) |
Gallbladder cancer (GBC) | 78 | 71 (91.0) | 67 (85.9) | 54 (69.2) | 7 (8.9) |
Positive likelihood rate | 17.8% | 22.6% | 100% | 100% |
Table 8 Correlations between carcinoembryonic antigen, cancer antigen 125, cancer antigen 242, and cancer antigen 199 expression and lymph node metastasis
Table 9 Carcinoembryonic antigen, cancer antigen 125, cancer antigen 242, and cancer antigen 199 expressions during follow-up
Table 10 Results of Cox proportional hazards model for multivariate regression analysis
Prognostic factor | Parameter estimate | Waldχ2 | P value | HR | 95%CI |
CEA | -0.043 | 0.498 | 0.48 | 0.957 | 0.849-1.080 |
CA199 | 0.005 | 12.076 | 0.001 | 1.005 | 1.002-1.009 |
CA242 | -0.007 | 0.386 | 0.535 | 0.993 | 0.972-1.015 |
CA125 | 0.003 | 0.714 | 0.398 | 1.003 | 0.996-1.009 |
Surgical modality | 0.569 | 2.450 | 0.118 | 1.766 | 0.866-3.599 |
LN metastasis | 1.191 | 3.276 | 0.07 | 3.291 | 0.906-11.957 |
Position (neck) | -1.578 | 6.358 | 0.012 | 0.206 | 0.061-0.704 |
Age | -0.010 | 0.073 | 0.787 | 0.990 | 0.922-1.063 |
Sex | 0.796 | 2.508 | 0.113 | 2.216 | 0.828-5.932 |
- Citation: Wang YF, Feng FL, Zhao XH, Ye ZX, Zeng HP, Li Z, Jiang XQ, Peng ZH. Combined detection tumor markers for diagnosis and prognosis of gallbladder cancer. World J Gastroenterol 2014; 20(14): 4085-4092
- URL: https://www.wjgnet.com/1007-9327/full/v20/i14/4085.htm
- DOI: https://dx.doi.org/10.3748/wjg.v20.i14.4085