CEA、CA19-9联合NLR对胆囊癌患者术后 生存预后的预测价值

Predictive Value of Combined CEA, CA19-9, and NLR for Postoperative Survival Prognosis in Patients with Gallbladder Carcinoma

摘要: 目的：探究CEA、CA19-9联合NLR对胆囊癌术后患者生存预后的预测价值。方法：回顾性纳入2016年6月至2023年6月于我院行胆囊癌根治性手术的123例胆囊癌患者。收集术前血清CEA、CA19-9、NLR水平，以及临床病理资料。采用Cox多因素分析，筛选独立预后因素。通过受试者工作特征(ROC)曲线分析并比较各指标及其联合预测因子对患者生存预后的预测效能。结果：123例患者中生存组与死亡组在黄疸、肿瘤分化程度、TNM分期、CA19-9、CEA、NLR方面比较，差异均有统计学意义(p < 0.05)。术前黄疸、TNM分期(III、IV期)、CEA > 5 ng/ml、CA19-9 > 39 U/ml、NLR升高是影响胆囊癌患者术后预后的独立危险因素(p < 0.05)。ROC分析显示CEA、CA19-9与NLR联合检测指标对患者预后预测价值最高(AUC = 0.786)。结论：CEA、CA19-9联合NLR对胆囊癌术后患者生存预后具有较高的预测价值。

Abstract: Objective: To investigate the predictive value of combining CEA, CA19-9, and NLR for the survival prognosis of patients after gallbladder cancer surgery. Methods: A retrospective analysis was conducted on 123 patients who underwent radical surgery for gallbladder cancer at our hospital from June 2016 to June 2023. Preoperative serum levels of CEA, CA19-9, and NLR, along with clinicopathological data, were collected. Multivariate Cox analysis was used to identify independent prognostic factors. The predictive performance of each indicator and its combined predictor was evaluated and compared using receiver operating characteristic (ROC) curve analysis. Results: Among the 123 patients, significant differences were observed between the survival and death groups in terms of jaundice, tumor differentiation degree, TNM stage, CA19-9, CEA, and NLR (all p < 0.05). Preoperative jaundice, TNM stage (III/IV), CEA > 5 ng/ml, CA19-9 > 39 U/ml, and elevated NLR were identified as independent risk factors affecting postoperative prognosis (p < 0.05). ROC analysis showed that the combined detection of CEA, CA19-9, and NLR had the highest predictive value for patient prognosis (AUC = 0.786). Conclusion: The combination of CEA, CA19-9, and NLR has high predictive value for the survival prognosis of patients after gallbladder cancer surgery.