title: Serum carbohydrate antigen (CA) 19-9 as a prognostic factor in cholangiocarcinoma: a meta-analysis.
abstract: This study was performed to determine the prognostic role of preoperative serum carbohydrate antigen (CA) 19-9 levels in the survival of patients with cholangiocarcinoma. Articles published up to June 1(st), 2010 that evaluated preoperative CA19-9 levels and the prognosis of cholangiocarcinoma were collected for meta-analysis. The required information for calculating individual relative risk (RR) was extracted from the studies, and a combined overall RR was estimated. Nine eligible studies were included. One study dealt with extra-hepatic cholangiocarcinoma, while the other eight studies analyzed intra-hepatic cholangiocarcinoma. The mean methodological quality score was 74.1%, ranging from 65.5% to 82.5%. The overall RR for the nine studies was 1.28 (95% confidence interval = 1.10-1.46), and the Z-score for overall effect was 13.83 (P<0.001). The association between serum CA19-9 level and lymph node involvement was also assessed. The combined RR was 1.471 (95% confidence interval = 0.411-5.264) and Z-score for overall effect was 0.59 (P = 0.553). CA19-9 levels were associated significantly with the prognosis of patients with cholangiocarcinoma. This meta-analysis shows that elevation of preoperative CA19-9 levels is correlated with a poor prognosis of patients with cholangiocarcinoma. However, larger scale and randomized studies are needed to draw a more substantive conclusion.
authors.affiliation: Department of Hepatobiliary Surgery, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430022, China.
authors.forename: Shang-Long
authors.initials: SL
authors.lastname: Liu
authors.forename: Zi-Fang
authors.initials: ZF
authors.lastname: Song
authors.forename: Qing-Gang
authors.initials: QG
authors.lastname: Hu
authors.forename: Duo
authors.initials: D
authors.lastname: Shan
authors.forename: Shao-Bo
authors.initials: SB
authors.lastname: Hu
authors.forename: Jun
authors.initials: J
authors.lastname: Li
authors.forename: Qi-Chang
authors.initials: QC
authors.lastname: Zheng
mesh_terms: D001650:Bile Duct Neoplasms / Q000097:blood* / Q000401:mortality* / Q000601:surgery; D001653:Bile Ducts, Intrahepatic; D018395:CA-19-9 Antigen / Q000097:blood*; D018281:Cholangiocarcinoma / Q000097:blood* / Q000401:mortality* / Q000601:surgery; D006801:Humans; D011379:Prognosis; D012306:Risk; D016896:Treatment Outcome
chemical_list: D018395:CA-19-9 Antigen