Purpose: In intrahepatic cholangiocarcinoma (ICC), the interactions among CA19-9, CA125, and CEA are not yet fully understood. This study aims to investigate the relationship between a combined grading system of CA19-9, CA125, and CEA (3C grade) and the prognosis of ICC patients, as well as its predictive capability for prognosis.
Methods: The patients were categorized into different 3C grades based on preoperative serum levels of CA19-9, CA125, and CEA to explore the relationship between 3C grade and overall survival (OS) and recurrence-free survival (RFS), assessing the predictive value of 3C grade for OS and RFS.
Results: A total of 535 eligible patients were included and were classified into different 3C grade groups. Significant differences were observed among different 3C grade groups in clinical characteristics such as tumor size (P = 0.006) and lymph node metastasis (P = 0.006). The Kaplan-Meier curves demonstrated significant differences in OS and RFS among the different 3C grade groups (P < 0.001). The receiver operating characteristic curve analysis revealed that the 3C grade had superior predictive value for OS and RFS compared to individual tumor markers (P < 0.05 for each).
Conclusion: This study revealed that the 3C grade was identified as an independent prognostic factor for OS and RFS after radical surgery of ICC, demonstrating superior predictive value for OS and RFS compared to single tumor markers. The 3C grade model holds promise to assist clinicians in preoperative assessment of ICC patients undergoing radical surgery, thereby aiding in the development of personalized treatment strategies.
Keywords: CA-125 antigen; CA-19-9 antigen; Carcinoembryonic antigen; Cholangiocarcinoma; Prognosis.
Copyright © 2025, the Korean Surgical Society.