机构:[1]Department of Hepatobiliary Surgery, The Fourth Afliated Hospital of Hebei Medical University, Hebei, China[2]Jianhua Campus, Hebei Medical University, shijiazhuang, China.
Background and aimsIn recent years, more and more inflammatory indicators have been studied to predict the long-term survival of patients with ampullary carcinoma (AC) after radical resection, but these prognostic indicators are still controversial. Therefore, based on previous inflammation scores, this study established a novel, easily accessible, more feasible and more predictive prognostic marker [Carbohydrate antigen199 to gamma-glutamyltransferase ratio (CA19-9/GGT)] to better assess the prognostic significance in AC patients undergoing radical resection.MethodsOverall survival (OS) and recurrence-free survival (RFS) were analyzed by Cox regression model. Correlation between CA19-9/GGT and clinicopathological variables were analyzed by Chi-squared test, Fisher ' s exact test, independent sample t test and Mann-Whitney U test. The performance of prognostic indexes is compared by the consistency index (C-index). The prediction accuracy of nomogram is further confirmed by calibration curve and decision curve analysis (DCA).ResultsCA19-9/GGT was an independent risk factor affecting OS [P = 0.001, hazard ratio (HR) 2.459, 95% confidence intervals (CI) 1.450-4.167] and RFS (P = 0.002, HR 2.333, 95% CI 1.371-3.971) in multivariate analysis. The optimal cut-off value of CA19-9/GGT was 0.14. In CA19-9/GGT correlation analysis, high risk group (> 0.14) was significantly associated with poor prognosis. The predictive performance of CA19-9/GGT (OS: C-index = 0.753, RFS: C-index = 0.745) was confirmed to be superior to other prognostic indicators according to the C-index. Compared with the simple AJCC staging system, the Nomogram prediction model (OS: C-index = 0.787, RFS: C-index = 0.795) established by the combination of CA19-9/GGT and AJCC 8th TNM staging system has higher prediction accuracy.ConclusionsCA19-9/GGT was an independent prognostic indicator after radical resection of AC. Incorporating CA19-9/GGT into the AJCC TNM staging system optimized the prediction accuracy of the TNM staging system, and further verified the predictive value of CA19-9/GGT.
第一作者机构:[1]Department of Hepatobiliary Surgery, The Fourth Afliated Hospital of Hebei Medical University, Hebei, China
共同第一作者:
通讯作者:
推荐引用方式(GB/T 7714):
Chen Rui-Qiu,Zhang Zhi-Lei,Jia Yu-Ming,et al.Preoperative CA19-9 and GGT ratio as a prognostic indicator in ampullary carcinoma[J].BMC GASTROENTEROLOGY.2023,23(1):doi:10.1186/s12876-022-02623-0.
APA:
Chen, Rui-Qiu,Zhang, Zhi-Lei,Jia, Yu-Ming,Chen, Rui-Xiang&Peng, Li.(2023).Preoperative CA19-9 and GGT ratio as a prognostic indicator in ampullary carcinoma.BMC GASTROENTEROLOGY,23,(1)
MLA:
Chen, Rui-Qiu,et al."Preoperative CA19-9 and GGT ratio as a prognostic indicator in ampullary carcinoma".BMC GASTROENTEROLOGY 23..1(2023)