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Clinical Trial
. 2020 Sep 20:26:e925017.
doi: 10.12659/MSM.925017.

The Clinical Role of Preoperative Serum CA19-9 and Carcinoembryonic Antigen (CEA) Levels in Evaluating the Resectability of Advanced Gallbladder Cancer

Wencong Ma  1 , Wei Li  1 , Jinghan Wang  1 , Rui Wu  1 , Chen Liu  1 , Feiling Feng  1 , Xiaoqing Jiang  1
Affiliations
Clinical Trial

The Clinical Role of Preoperative Serum CA19-9 and Carcinoembryonic Antigen (CEA) Levels in Evaluating the Resectability of Advanced Gallbladder Cancer

Wencong Ma et al. Med Sci Monit. .

Abstract

BACKGROUND The present study was designed to study the ability of preoperative serum concentrations of the tumor-associated biomarkers carcinoembryonic antigen (CEA), carbohydrate antigen 19-9 (CA19-9) and adjusted CA19-9 to assess the resectability of advanced gallbladder cancer (GBC). MATERIAL AND METHODS This retrospective study included patients with potentially resectable stage II-IV (AJCC 8th) GBC examined at our institution between January 2012 and December 2016. Receiver operating characteristic (ROC) curve analysis was used to determine the predictive value and optimal cut-off point of tumor-associated biomarkers for curative resection. RESULTS Pathological examination of the 309 patients included in this study found that 169 (54.7%) underwent R0 (curative) resection, whereas 121 (39.2%) underwent R1/2 (non-curative) resection, and 19 (6.1%) were unresectable. The mean serum concentrations of CEA, CA19-9 and adjusted CA19-9 were significantly lower in patients who underwent R0 resection than in the other groups. ROC curve analysis showed that adjusted CA19-9 concentration was better able to predict resectability (area under the curve, 0.774; 95% confidence interval, 0.722-0.826; P<0.001) than total bilirubin, CEA, and CA19-9 concentrations. The optimal cut-off for adjusted CA19-9 concentration was 47.63 U/mL, which had a sensitivity of 69.82%, a specificity of 75%, a positive predictive value of 77.12% and a negative predictive value of 67.31%. CONCLUSIONS Adjusted CA19-9 concentration is an easily calculated parameter superior to CA19-9 and CEA concentrations in predicting the resectability of advanced gallbladder cancer.

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Conflict of interest statement

Conflict of interest

None.

Figures

Figure 1
Figure 1
ROC curves for preoperative serum CEA, total bilirubin, CA19-9, and adjusted CA19-9 levels in the determination of the resectability of gallbladder cancer.
Figure 2
Figure 2
Kaplan-Meier survival curves for patients who underwent R0 and R1/2 resection and those with unresectable tumors.
See this image and copyright information in PMC

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