Value of combined detection of portal vein blood CTCs, CAR, and CA199/CA50 ratio in assessing survival after radical resection for pancreatic cancer
HUANG Rang-lang,MI Liang-liang,ZHANG Ze-yu
Abstract:
Objective To study the combined assessment of survival after radical pancreatic cancer resection by portal vein circulating tumor cells (CTCs), C-reactive protein/clear protein (CAR), and glycoantigen 199/glycoantigen 50 (CA199/CA50) ratio. Methods Eighty-three patients admitted to our hospital from January 2018 to January 2020 who underwent radical pancreatic cancer resection were selected. The CTCs, CAR, and CA199/CA50 levels of patients' portal vein blood were detected, and the CTCs, CAR, and CA199/CA50 levels of different pathological features were compared; the patients were followed up for 2 years, and the CTCs, CAR, and CA199/CA50 levels of portal vein blood of the patients who survived and those who died were analyzed, and CTCs, CAR, and CA199/CA50 levels of the patients who survived and those who died were analyzed by using the working characteristic curves of the subjects, CA199/CA50 to assess the value of patients' postoperative survival, and Kaplan-Meier survival curves were used to analyze the effects of CTCs, CAR, CA199/CA50 on patients with hepatocellular carcinoma. Results The levels of portal blood CTCs, CAR, and CA199/CA50 were significantly higher in patients with the presence of lymph node metastasis, TNM stage III, and low degree of differentiation than in patients without lymph node metastasis TNM stage I-II, and intermediate to high degree of differentiation (P<0.05). Surviving patients had lower levels of portal vein blood CTCs, CAR and CA199/CA50 compared with deceased patients (P<0.05). The sensitivity of portal vein blood CTCs, CAR, and CA199/CA50 for the prognostic assessment of patients undergoing resection for radical pancreatic cancer was 78.9%, 78.8% and 73.7%, respectively, and the specificity was 90.6%, 91.0% and 91.2%, respectively, and the combination of all three had a sensitivity of 89.5% and specificity of 93.7% for the prognostic assessment of patients undergoing resection for radical pancreatic cancer. The sensitivity and specificity of the combination of the three tests for the prognosis of patients undergoing radical pancreatic cancer resection were higher than those of the individual tests. 86.00% of the survival rate in the CTCs normal group (n=50) was higher than that in the CTCs elevated group (n=33) (63.63%). 82.97% of the survival rate in the CAR normal group (n=47) was higher than that in the CAR elevated group (n=36) (69.44%). The survival rate of the CA199/CA50 normal group (n=53) was 88.67%, higher than that of the CA199/CA50 elevated group (n=30) of 56.66%, which the difference was statistically significant (P<0.05). Conclusion The combined assessment of survival after radical pancreatic cancer resection by portal vein blood CTCs, CAR and CA199/CA50 ratio is of high value, and the sensitivity and specificity of the combination of the three is higher than that of each individual test.
