Abstract: Objective To investigate the predictive role of serum carcinoembryonic antigen (CEA), carbohydrate antigen 125 (CA125) and carbohydrate antigen 199 (CA199) in prediction of the prognosis of advanced intrahepatic cholangiocarcinoma (ICC). Methods The clinical data of 120 patients with ICC in the hospital between 2015 and 2018 were retrospectively analyzed. The patients were divided into good prognosis and poor prognosis according to the disease progression and time of survival in one year follow-up. Logistic regression analysis was used to identify the related risk factors. Subject working curve was drawn, and the predictive significance of serum CEA, CA125, and CA199 was analyzed . Results Ninety-one patients had poor prognosis, including 72 deaths and 19 survivals with disease progression. The incidence of poor prognosis was 75.83%, with high levels of serum CEA, CA125 and CA199 (P<0.05). There were no significant differences between the two groups in gender, age, tumor diameter, hepatitis, cirrhosis, Child-Pugh classification, treatment methods as well as the blood AFP concentration (P>0.05). The independent risk factors for the patients with poor prognosis include multiple tumors, low differentiation and high TBIL≥171 μmol/mL (P<0.05). Logistic regression analysis showed that elevated CEA （>9.67 ng/mL）, CA125 (> 93.23 U/mL), CA199 (> 120.11 U/mL), and TBIL(>171 mmol/mL) and multiple tumors with low differentiation were independent risk factors for poor prognosis in patients with advanced ICC (P<0.05). The best cut-off points of serum CEA, CA125 and CA199 for predicting poor prognosis were 9.67 ng/mL, 93.23 U/mL and 120.11 U/mL, respectively. The sensitivity, specificity and accuracy of combined detections of serum CEA, CA125 and CA199 were higher than those of single detection, and the AUC of combined detection was 0.832, higher than that of single detection. Conclusion The serum levels of CEA, CA125 and CA199 are closely related to poor prognosis in patients with advanced ICC, and compared with the serum CEA, CA125 and CA199 detected alone, the serological indicators of the combination detection of the three have higher predictive value for prognosis of patients with advanced ICC.

Key words: Carcinoembryonic, antigen, Carbohydrate, antigen125, Carbohydrate, antigen, 199, Advanced, intrahepatic, cholangiocarcinoma, Prognosis