RECIST 1.1版联合CA19-9双指标分层对晚期胰腺癌患者化疗的预后评估价值

刘壮; 刘丁瑕; 汤伟; 彭卫军; 顾雅佳; 童彤

doi:10.19732/j.cnki.2096-6210.2026.02.003

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RECIST 1.1版联合CA19-9双指标分层对晚期胰腺癌患者化疗的预后评估价值

专题论著 | 更新时间：2026-05-07

- RECIST 1.1版联合CA19-9双指标分层对晚期胰腺癌患者化疗的预后评估价值
- Prognostic value of an integrated RECIST v1.1 and CA19-9 dual-marker stratification model in advanced pancreatic cancer patients undergoing chemotherapy
- 肿瘤影像学 2026年35卷第2期页码：230-238
- 作者机构：
  
  复旦大学附属肿瘤医院放射诊断科，复旦大学上海医学院肿瘤学系，上海 200032
- 作者简介：
  
  [ "童彤，主任医师，博士研究生导师，复旦大学附属肿瘤医院放射诊断科主任兼医技1支部书记。中国抗癌协会肿瘤影像专业委员会常务委员，中华医学会放射学分会青年学组委员，上海市抗癌协会肿瘤影像专业委员会常务委员，上海市医学会放射科专科分会青年委员会副主任委员，上海市生物医学工程学会放射医学工程专业委员会常务委员，美国纪念斯隆-凯特琳癌症中心（MSKCC）访问学者。上海市医学会第二届“青年菁英”人才计划，复旦大学上海医学院“青年临床科学家培养计划”，复旦大学“卓越2025”卓学优秀人才。主攻方向为消化道肿瘤功能影像及人工智能研究，以第一负责人承担多项国家及省部级科研基金项目，其中国家自然科学基金3项。以第一作者及通信作者在国内外期刊发表学术论文50余篇，其中SCI收录期刊上发表学术论文30余篇。" ]
- 基金信息：
  
  无
- DOI：10.19732/j.cnki.2096-6210.2026.02.003
  中图分类号： R735.9;R445.3
- 收稿：2026-03-11，
  
  修回：2026-04-15，
  
  录用：2026-04-16，
  
  纸质出版：2026-04-28
- 稿件说明：
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刘　壮, 刘丁瑕, 汤　伟, 等. RECIST 1.1版联合CA19-9双指标分层对晚期胰腺癌患者化疗的预后评估价值［J］. 肿瘤影像学, 2026, 35(2): 230-238.

LIU Z, LIU D X, TANG WCitation:, et al. Prognostic value of an integrated RECIST v1.1 and CA19-9 dual-marker stratification model in advanced pancreatic cancer patients undergoing chemotherapy［J］. Oncoradiology, 2026, 35(2): 230-238.
刘　壮, 刘丁瑕, 汤　伟, 等. RECIST 1.1版联合CA19-9双指标分层对晚期胰腺癌患者化疗的预后评估价值［J］. 肿瘤影像学, 2026, 35(2): 230-238. DOI： 10.19732/j.cnki.2096-6210.2026.02.003.

LIU Z, LIU D X, TANG WCitation:, et al. Prognostic value of an integrated RECIST v1.1 and CA19-9 dual-marker stratification model in advanced pancreatic cancer patients undergoing chemotherapy［J］. Oncoradiology, 2026, 35(2): 230-238. DOI： 10.19732/j.cnki.2096-6210.2026.02.003.

摘要

目的

探讨实体瘤临床疗效评价标准（response evaluation criteria in solid tumor，RECIST）1.1版联合血清糖类抗原19-9（carbohydrate antigen 19-9，CA19-9）双指标分层模型在接受一线化疗的晚期胰腺癌患者中的预后预测价值。

方法

回顾并连续纳入2020年4月—2022年7月于复旦大学附属肿瘤医院接受一线化疗的晚期胰腺癌患者，化疗方案包括吉西他滨联合白蛋白结合型紫杉醇化疗方案（AG）、AG联合程序性死亡［蛋白］配体-1（programmed death ligand-1，PD-L1）抑制剂方案及mFOLFIRINOX方案，根据化疗2个周期后的影像学（RECIST 1.1版）与生化反应（CA19-9下降≥50%），将患者分为双指标响应组、单一指标响应组和双指标无响应组。采用Kaplan-Meier法和log-rank检验比较各组总生存期（overall survival，OS）的差异，并进行亚组分析。

结果

纳入研究的69例患者中，双指标响应组43例（62.32%），单一指标响应组19例（27.54%），双指标无响应组7例（10.14%）。3组中位OS呈显著梯度差异：双指标响应组为404 d，显著优于其余两组（

=0.01，

=0.04）。亚组分析显示，mFOLFIRINOX方案中RECIST 1.1版预测效能更优（

=0.01），AG方案中CA19-9预测效能更优（

=0.01），而AG联合PD-L1抑制剂方案中两者预测效能均不佳。

结论

RECIST 1.1版联合CA19-9双指标分层模型能够有效区分晚期胰腺癌化疗患者的预后风险，较单一指标更有价值，且该模型简便易行，可为临床作出个体化治疗决策提供参考依据。

Abstract

Objective

To investigate the prognostic value of a dual-marker stratification model combining response evaluation criteria in solid tumor (RECIST) v1.1 and serum carbohydrate antigen 19-9 (CA19-9) in patients with advanced pancreatic cancer receiving first-line chemotherapy.

Methods

Patients with advanced pancreatic cancer who received first-line chemotherapy at Fudan University

Shanghai Cancer Center from April 2020 to July 2022 were retrospectively enrolled. Chemotherapy regimens included AG

AG combined with programmed death ligand-1 (PD-L1) inhibitor

and mFOLFIRINOX. Based on the radiological (RECIST v1.1) and biochemical (CA19-9 reduction ≥ 50%) responses after two cycles of chemotherapy

patients were classified into three groups: dual-marker responders (radiological non-progressive disease and biochemical response)

single-marker responders (either radiological or biochemical response)

and dual-marker non-responders (radiological progressive disease and non-biochemical response). Overall survival (OS) was compared among groups using Kaplan-Meier method and log-rank test

and subgroup analyses were performed.

Results

Among the 69 patients included in the study

43 patients (62.32%) were classified into the dual-marker response group

19 (27.54%) into the single-marker response group

and 7 (10.14%) into the dual-marker non-response group. The median OS showed a significant gradient among the three groups: the dual-marker response group had a median OS of 404 days

which was significantly longer than that of the other two groups (

=0.01 and

=0.04

respectively). Subgroup analysis revealed that RECIST v1.1 had better predictive performance in the mFOLFIRINOX subgroup (

=0.01)

while CA19-9 showed superior predictive value in the AG subgroup (

=0.01). However

neither single nor combined indicators effectively predicted prognosis in the AG combined with PD-L1 inhibitor subgroup.

Conclusion

The dual-marker stratification model combining RECIST v1.1 and CA19-9 effectively distinguishes the prognosis of patients with advanced pancreatic cancer receiving chemotherapy

providing incremental value over single indicators. This model is simple and practical

offering reference for individualized treatment decisions.

关键词

Keywords

references

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