血胆汁酸水平与胰腺癌临床特征及预后的关系

Total Bile Acid Levels in Pancreatic Ductal Adenocarcinoma: Correlation with Clinical Characteristics and Prognosis

摘要: 目的：探讨外周血胆汁酸(Total bile acid, TBA)水平与胰腺导管腺癌(Pancreatic ductal adenocarcinoma, PDAC)患者临床特征及预后的关系。方法：回顾性分析2021年1月至2022年12月在我院病理确诊为PDAC的144例患者临床病理资料及随访数据。结果：高胆汁酸组高血压、冠心病显著高于低胆汁酸组(P < 0.05)；高胆汁酸组总胆红素、直接胆红素、谷草转氨酶、谷氨酰转肽酶、碱性磷酸酶显著高于低胆汁酸组(P < 0.05)；高胆汁酸组胰头癌占比显著高于低胆汁酸组(P < 0.05)。在全部患者中，低胆汁酸组与高胆汁酸组中位生存期分别为13.06个月和16.19个月，中位无复发生存期分别为7.33个月和9.87个月，两组患者生存期无显著统计学差异(P = 0.351)；在胰头癌亚组中，低胆汁酸组与高胆汁酸组中位生存期分别为12.30个月和15.87个月，中位无复发生存期分别为7.01个月和10.82个月，两组患者生存期无显著统计学差异(P = 0.052)。结论：外周血TBA水平与PDAC患者的特定临床病理特征显著相关，提示其可能作为评估患者病情和预测预后的潜在生物标志物。

Abstract: Objective: To explore the association between the level of total bile acid (TBA) and the clinical characteristics and prognosis of patients with pancreatic ductal adenocarcinoma (PDAC). Methods: This retrospective analysis enrolled 144 pathologically confirmed PDAC patients from our institution between January 2021 and December 2022. The study encompassed their clinical, pathological, and follow-up data. Results: The high bile acid group had a significantly higher incidence of hypertension and coronary heart disease than the low bile acid group (P < 0.05). The total bilirubin (TBIL), direct bilirubin (DBIL), aspartate aminotransferase (AST), gamma-glutamyl transferase (GGT), and alkaline phosphatase (GGT) levels in the high bile acid group were all significantly elevated in the high bile acid group compared to the low bile acid group (P < 0.05). Pancreatic head cancer was significantly more common in the high-bile-acid group than in the low-bile-acid group (P < 0.05). For the entire cohort, the median overall survival was 13.06 months in the low bile acid group and 16.19 months in the high bile acid group, while the median recurrence-free survival was 7.33 months and 9.87 months, respectively. No statistically significant difference in overall survival was observed between the two groups (P = 0.351). In the pancreatic head cancer subgroup, the median overall survival was 12.30 months in the low bile acid group and 15.87 months in the high bile acid group, with median recurrence-free survival times of 7.01 months and 10.82 months, respectively. The difference in overall survival between the two groups did not reach statistical significance (P = 0.052). Conclusions: The level of TBA is significantly associated with specific clinicopathological features in patients with PDAC, suggesting that it may serve as a potential biomarker for assessing disease status and prognosis.