Bile duct cell carcinoma, which is not easily detected, can be effectively prevented from recurrence and metastasis through cell therapy

Tumor Marker CA19-9

CA19-9 is a relevant marker for pancreatic cancer, gastric cancer, colorectal cancer, and gallbladder cancer. Numerous studies have shown that CA19-9 concentration is related to the size of these tumors, making it the most sensitive marker reported to date for pancreatic cancer. The positive rate for gastric cancer, colorectal cancer, gallbladder cancer, bile duct cancer, and liver cancer is also high, indicating that CA19-9 is a marker associated with digestive system tumors.

Serum CA19-9 levels can reflect tumor burden to some extent or suggest the possibility of micrometastases. In addition to diagnostic significance, CA19-9 can also be used to evaluate prognosis and treatment efficacy. Although elevated serum CA19-9 levels in pancreatic cancer patients after surgery may indicate recurrence or metastasis, a comprehensive judgment should be made in conjunction with imaging evidence.

Some benign diseases can also cause elevated CA19-9 levels, such as certain gynecological diseases (ovarian cysts, adenomyosis, etc.); cholecystitis, hepatitis B, etc.; thyroid-related diseases, etc. Therefore, upon discovering elevated CA19-9 levels, imaging examinations should be immediately conducted to assist in determining whether it is a malignant tumor.

Hepatocellular carcinoma

Primary liver cancer includes two types: one is hepatocellular carcinoma originating from the liver, and the other is cholangiocarcinoma originating from the intrahepatic bile duct. The incidence rate of cholangiocarcinoma is relatively low (90% of primary liver cancer is hepatocellular carcinoma), and unlike hepatocellular carcinoma, cholangiocarcinoma is more prone to lymph node metastasis.

The early symptoms of cholangiocarcinoma are not obvious, and the tumor marker AFP does not increase. Liver cancer is often discovered incidentally during imaging examinations or when liver function abnormalities occur. Even if the tumor has grown significantly, many patients still do not exhibit any clinical symptoms, and the disease is often discovered at a late stage, leading to a poor prognosis. Therefore, regular screening for individuals over 45 years old with high-risk factors is helpful for the early diagnosis and timely treatment of cholangiocarcinoma.

Ms. Zhang underwent NKT cell immunotherapy in January 2021, and has completed 28 courses of treatment, totaling 14 months (as of April 2022).No clear signs of disease progression were observed during the two imaging follow-ups conducted after the initiation of NKT treatment.

Image Aspects

 

Abdominal imaging: Post-left hemihepatectomy changes, no significant changes from December 2020 to April 2022, no obvious abnormal signal shadow in the surgical area, regular follow-up recommended; Slight dilation of the common bile duct was observed during two follow-up examinations in October 2021 and January 2022; Abdominal and liver plain scan + diffusion MRI performed in April 2022 revealed abnormal signal shadow in liver S6, compared to the MRI on October 12, 2021, suggesting a new finding, short-term follow-up recommended, mild dilation of intrahepatic and extrahepatic bile ducts. Pelvic CT performed from March 2021 to January 2022 showed uneven density enhancement of the uterus, suggesting uterine fibroids.

 

 Swelling  < H359>

 

Tumor markers: CA72-4 was above the normal range from March 2021 to April 2022, with intermittent increases, requiring close observation; Fer increased from December 2020 to January 2021, but was within the normal range during the follow-up examination from March 2021 to April 2022; CA19-9 remained within the normal range during all follow-up examinations from December 2020 to April 2022, requiring close observation.

Quality of Life

 

Ms. Zhang's quality of life has been greatly improved. Her mental state is excellent, and she feels more energetic and vigorous than before, having returned to her pre-illness state. She leads a normal life and works without being affected by the disease.

 

Conclusion   Theory

 

Ms. Zhang achieved the expected results after adopting NKT cell therapy. With the combined effects of various immunotherapies, after more than a year, the latest assessment result remains stable with no progression observed. Immunotherapy is considered one of the most promising directions in tumor treatment, and Ms. Zhang's case serves as a good illustration of this point.

Popular science knowledge is provided for reference only, and individual patients should follow clinical medical advice.                    

Classic NKT case review

Click on the image

to view