The Prognostic Value of the CA19-9/TBIL Ratio in Patients With Biliary Tract Cancers (BTCs): A Retrospective Study

The Prognostic Value of the CA19-9/TBIL Ratio in Patients With Biliary Tract Cancers (BTCs): A Retrospective Study | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Research The Prognostic Value of the CA19-9/TBIL Ratio in Patients With Biliary Tract Cancers (BTCs): A Retrospective Study Jianchun Xiao, Li Wang, Tao Hong, Binglu Li, Wei Liu, Qiang Qu, and 2 more This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-75476/v1 This work is licensed under a CC BY 4.0 License Status: Published Journal Publication published 22 Feb, 2021 Read the published version in Journal of Oncology → Version 1 posted You are reading this latest preprint version Abstract Introduction: Incidence of biliary tract cancers (BTCs) in China is high, and surgery is the only curative option. Preoperative CA19-9 has been identified as a predictor for survival in patients with resectable BTCs, but more potential predictors need to be studied. This retrospective study aimed to establish the prognostic significance of CA19-9/TBIL ratio (CTR) in patients with BTCs. Methods: A retrospective analysis was performed in patients who diagnosed with BTCs and received surgical resection between 2013 and 2018 at PUMCH. Demographic and clinical parameters were collected. Preoperative CA19-9 and CTR were classified as elevated (> 58.6 and > 0.83) according to the receiver operating characteristics (ROC) analysis. Demographic and clinical parameters were compared between the groups using Student’s t-test, chi-square, or Fisher’s exact test. Survival analysis was performed by the Kaplan-Meier methods and the relationship between variables and survival was assessed by the log-rank test. Cox regression analysis was conducted to identify potential risk factors for overall survival. Results: In total 109 participants were involved in the final analysis. The overall survival rate was 18.0% at 5 years, with a median survival duration of 1.58 years. The Kaplan-Meier analysis indicated that higher CTR was associated with shorter OS (15 vs. 50, p < 0.01). Univariate survival analysis identified TNM staging, CA19-9, and CTR as statistically significant prognostic factors. In a multiple COX analysis, only CTR was proved as a significantly independent prognostic factor. Conclusion: CTR acts as an independent prognostic predictor for patients with biliary tract cancer. Oncology Incidence of biliary tract cancers (BTCs) CA19-9/TBIL ratio (CTR) receiver operating characteristics (ROC) Figures Figure 1 Figure 2 Figure 3 Full Text Cite Share Download PDF Status: Published Journal Publication published 22 Feb, 2021 Read the published version in Journal of Oncology → Version 1 posted You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. As a division of Research Square Company, we’re committed to making research communication faster, fairer, and more useful. We do this by developing innovative software and high quality services for the global research community. Our growing team is made up of researchers and industry professionals working together to solve the most critical problems facing scientific publishing. Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-75476","acceptedTermsAndConditions":true,"allowDirectSubmit":true,"archivedVersions":[],"articleType":"Research","associatedPublications":[],"authors":[{"id":2389590,"identity":"c7bd0af1-6aba-464a-8307-ccac25c1bc1d","order_by":0,"name":"Jianchun Xiao","email":"","orcid":"","institution":"Peking Union Medical College Hospital Department of General Surgery","correspondingAuthor":false,"submittingAuthor":false,"prefix":"","firstName":"Jianchun","middleName":"","lastName":"Xiao","suffix":""},{"id":2389591,"identity":"0c4f84a2-40b0-479b-a775-7f6743b4716e","order_by":1,"name":"Li Wang","email":"","orcid":"","institution":"Peking Union Medical College Hospital Department of General Surgery","correspondingAuthor":false,"submittingAuthor":false,"prefix":"","firstName":"Li","middleName":"","lastName":"Wang","suffix":""},{"id":2389592,"identity":"44068ad5-4180-4bf9-89f9-4b322d723f03","order_by":2,"name":"Tao Hong","email":"","orcid":"","institution":"Peking Union Medical College Hospital Department of General Surgery","correspondingAuthor":false,"submittingAuthor":false,"prefix":"","firstName":"Tao","middleName":"","lastName":"Hong","suffix":""},{"id":2389593,"identity":"52316da0-b394-482b-a048-fcc512a14691","order_by":3,"name":"Binglu Li","email":"","orcid":"","institution":"Peking Union Medical College Hospital Department of General Surgery","correspondingAuthor":false,"submittingAuthor":false,"prefix":"","firstName":"Binglu","middleName":"","lastName":"Li","suffix":""},{"id":2389594,"identity":"86edec1a-10dc-4602-a510-2ff5fe8f1ea2","order_by":4,"name":"Wei Liu","email":"","orcid":"","institution":"Peking Union Medical College Hospital Department of General Surgery","correspondingAuthor":false,"submittingAuthor":false,"prefix":"","firstName":"Wei","middleName":"","lastName":"Liu","suffix":""},{"id":2389595,"identity":"9887f0b7-037f-4ab1-9820-c73b846200e5","order_by":5,"name":"Qiang Qu","email":"","orcid":"","institution":"Peking Union Medical College Hospital Department of General Surgery","correspondingAuthor":false,"submittingAuthor":false,"prefix":"","firstName":"Qiang","middleName":"","lastName":"Qu","suffix":""},{"id":2389596,"identity":"7840bd54-7342-4f24-938d-35b5f719f152","order_by":6,"name":"Chaoji Zheng","email":"","orcid":"","institution":"Peking Union Medical College Hospital Department of General Surgery","correspondingAuthor":false,"submittingAuthor":false,"prefix":"","firstName":"Chaoji","middleName":"","lastName":"Zheng","suffix":""},{"id":2389597,"identity":"10160527-c7cf-4a56-a8d1-90f0c26332c0","order_by":7,"name":"Xiaodong He","email":"data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAZAAAAAyAQMAAABI0h/eAAAABlBMVEX///8AAABVwtN+AAAACXBIWXMAAA7EAAAOxAGVKw4bAAAA4klEQVRIie3RPQrCMBiA4Q8C7RLt2kF6hq8ErKKHSRHqIiK4ODo55QBeQvAIkWBdKq7Z1F1ENwdFoyBubd0E80LIkof8AdhsPxiaIQGImSjgCdvBdyScDhJWisCbEHpScSGJXBHKy6gVRN5MDttIOLhqOc8jTZHyhci6rDk9ctZDpw80SXTuwXRHyspExXOdoSF0CD6t55Ptfry4vUkD/XhcSDSR6rXLRiADxBIkS7iqmbugrvJQIGdO4V1WGTsfzIvhZp3i5XoPPFelueSTz53XJznllj/zJNmVX22z2Wz/1ANU1FA67lKs2AAAAABJRU5ErkJggg==","orcid":"https://orcid.org/0000-0002-3316-9457","institution":"Department of General Surgery, Peking Union Medical College Hospital, Beijing 6 100730, China.","correspondingAuthor":true,"submittingAuthor":false,"prefix":"","firstName":"Xiaodong","middleName":"","lastName":"He","suffix":""}],"badges":[],"createdAt":"2020-09-10 10:45:02","currentVersionCode":1,"declarations":"","doi":"10.21203/rs.3.rs-75476/v1","doiUrl":"https://doi.org/10.21203/rs.3.rs-75476/v1","draftVersion":[],"editorialEvents":[{"content":"https://doi.org/10.1155/2021/5829893","type":"published","date":"2021-02-23T02:42:18+00:00"}],"editorialNote":"","failedWorkflow":false,"files":[{"id":2480361,"identity":"fbbae77d-ea5f-40d5-bd40-4a265dfd825f","added_by":"auto","created_at":"2020-09-18 16:03:13","extension":"jpg","order_by":1,"title":"Figure 1","display":"","copyAsset":false,"role":"figure","size":40796,"visible":true,"origin":"","legend":"ROC curves and area under the ROC curve for CTR and CA19-9 as a predictor for prognosis of patients with BTCs. CTR: CA19-9/TBIL Ratio; BTCs: Biliary tract cancers.","description":"","filename":"Fig1.JPG","url":"https://assets-eu.researchsquare.com/files/rs-75476/v1/Fig1.JPG"},{"id":2480362,"identity":"92fa76fb-0867-4a45-8325-9bf302a22925","added_by":"auto","created_at":"2020-09-18 16:03:13","extension":"jpg","order_by":2,"title":"Figure 2","display":"","copyAsset":false,"role":"figure","size":42211,"visible":true,"origin":"","legend":"(a) Kaplan-Meier Curve comparing overall survival for CTR ≤ 0.83 (blue) and CTR \u003e 0.83 (red), P \u003c 0.0001. (b) Kaplan-Meier Curve comparing overall survival for CA19-9 ≤ 58.6 (blue) and CA19-9 \u003e 58.6 (red), P = 0.00075. Vertical ticks represent censored patients, while numbers below the x-axis represent the number of patients at risk in each group in 20-month intervals. CTR: CA19-9/ TBIL Ratio.","description":"","filename":"Fig2.JPG","url":"https://assets-eu.researchsquare.com/files/rs-75476/v1/Fig2.JPG"},{"id":2480363,"identity":"1e4e0d56-deb1-49cb-860a-88ebebad1a03","added_by":"auto","created_at":"2020-09-18 16:03:13","extension":"jpg","order_by":3,"title":"Figure 3","display":"","copyAsset":false,"role":"figure","size":66887,"visible":true,"origin":"","legend":"Multivariate Cox regression analysis indicates that CTR is the only significant risk factor independently prognostic for OS. CTR: CA19-9/TBIL Ratio.","description":"","filename":"Fig3.JPG","url":"https://assets-eu.researchsquare.com/files/rs-75476/v1/Fig3.JPG"},{"id":13594189,"identity":"fc536da7-aefe-4635-8590-797f91e990b1","added_by":"auto","created_at":"2021-09-17 05:19:23","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":253759,"visible":true,"origin":"","legend":"","description":"","filename":"manuscript.pdf","url":"https://assets-eu.researchsquare.com/files/rs-75476/v1/ed81d5c8-bf6b-4099-98bc-c03edacd39a0.pdf"}],"financialInterests":"","formattedTitle":"\u003cp\u003eThe Prognostic Value of the CA19-9/TBIL Ratio in Patients With Biliary Tract Cancers (BTCs): A Retrospective Study\u003c/p\u003e","fulltext":[{"header":"Full Text","content":"\u003cp\u003eThis preprint is available for \u003ca href='/article/rs-75476/latest.pdf' target='_blank'\u003edownload as a PDF\u003c/a\u003e.\u003c/p\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":false,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":false,"highlight":"","institution":"","isAcceptedByJournal":true,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true},"keywords":"Incidence of biliary tract cancers (BTCs), CA19-9/TBIL ratio (CTR), receiver operating characteristics (ROC)","lastPublishedDoi":"10.21203/rs.3.rs-75476/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-75476/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003cp\u003eIntroduction: Incidence of biliary tract cancers (BTCs) in China is high, and surgery is the only curative option. Preoperative CA19-9 has been identified as a predictor for survival in patients with resectable BTCs, but more potential predictors need to be studied. This retrospective study aimed to establish the prognostic significance of CA19-9/TBIL ratio (CTR) in patients with BTCs.\u003c/p\u003e\u003cp\u003eMethods: A retrospective analysis was performed in patients who diagnosed with BTCs and received surgical resection between 2013 and 2018 at PUMCH. Demographic and clinical parameters were collected. Preoperative CA19-9 and CTR were classified as elevated (\u0026gt; 58.6 and \u0026gt; 0.83) according to the receiver operating characteristics (ROC) analysis. Demographic and clinical parameters were compared between the groups using Student’s t-test, chi-square, or Fisher’s exact test. Survival analysis was performed by the Kaplan-Meier methods and the relationship between variables and survival was assessed by the log-rank test. Cox regression analysis was conducted to identify potential risk factors for overall survival.\u003c/p\u003e\u003cp\u003eResults: In total 109 participants were involved in the final analysis. The overall survival rate was 18.0% at 5 years, with a median survival duration of 1.58 years. The Kaplan-Meier analysis indicated that higher CTR was associated with shorter OS (15 vs. 50, p \u0026lt; 0.01). Univariate survival analysis identified TNM staging, CA19-9, and CTR as statistically significant prognostic factors. In a multiple COX analysis, only CTR was proved as a significantly independent prognostic factor.\u003c/p\u003e\u003cp\u003eConclusion: CTR acts as an independent prognostic predictor for patients with biliary tract cancer.\u003c/p\u003e","manuscriptTitle":"The Prognostic Value of the CA19-9/TBIL Ratio in Patients With Biliary Tract Cancers (BTCs): A Retrospective Study","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2020-09-18 16:03:11","doi":"10.21203/rs.3.rs-75476/v1","editorialEvents":[{"type":"communityComments","content":0}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"f59b488a-612d-469d-9bc1-1e2c8027917f","owner":[],"postedDate":"September 18th, 2020","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"published-in-journal","subjectAreas":[{"id":551039,"name":"Oncology"}],"tags":[],"updatedAt":"2021-08-20T02:42:18+00:00","versionOfRecord":{"articleIdentity":"rs-75476","link":"https://doi.org/10.1155/2021/5829893","journal":{"identity":"journal-of-oncology","isVorOnly":true,"title":"Journal of Oncology"},"publishedOn":"2021-02-23 02:42:18","publishedOnDateReadable":"February 23rd, 2021"},"versionCreatedAt":"2020-09-18 16:03:11","video":"","vorDoi":"10.1155/2021/5829893","vorDoiUrl":"https://doi.org/10.1155/2021/5829893","workflowStages":[]},"version":"v1","identity":"rs-75476","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-75476","identity":"rs-75476","version":["v1"]},"buildId":"7rjqhiLT3MXkJMwkYKINL","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}