摘要
目的了解24h尿蛋白（Upro）水平和血清白蛋白（Salb）水平对慢性肾脏疾病（CKD）患者血清甲胎蛋白（AFP）、癌胚抗原（CEA）、糖蛋白抗原199（CA199）、糖蛋白抗原125（CA125）、糖蛋白抗原724（CA724）、糖蛋白抗原153（CA153）、前列腺特异抗原（PSA）、游离前列腺特异抗原（fPSA）、神经元特异性烯醇化酶（NSE）、细胞角化素蛋白片段19（CYFRA21-1）和鳞癌抗原（SCC）血清浓度的影响。方法根据Upro将232例CKD患者分为Upro〈1．5g／d组，Upro 1．5～3．5g／d组和Upro〉3．5g／d组，比较各组肿瘤标志物水平；再根据Salb水平将上述患者分为Salb〈25g／L组、Salb25-35g／L组和Salb〉35g／L组；对其中的男性患者亦按上述方法分组，比较各组PSA和fPSA水平。结果CA125、CA153、CYFRA21-1、NSE和SCC水平在不同蛋白尿组间差异存在统计学意义，相关分析显示其血清水平均与Upro呈正相关，而CEA、CA199、AFP、CA724、PSA和fPSA水平在各组间差异无统计学意义；CA199、CA125、CYFRA21-1、NSE和SCC水平在不同Salb组间差异存在统计学意义，且其血清水平均与Salb水平呈负相关，而CEA、AFP、CA153、CA724、PSA和fPSA水平在各组间差异无统计学意义。结论在大量蛋白尿伴或低白蛋白血症的患者中，部分血清肿瘤标志物诊断相应肿瘤的假阳性率增高。
Purpose Increased serum tumor markers strongly suggest the diagnosis of the corresponding tumors. We intended to know the effects of urinary protein excretion （Upro） and serum albumin （Salb） on the serum concentrations of tumor markers including AFP, CEA, CA199, CA125, CA724, CA153, PSA, fPSA, NSE, CYFRA21-1 and SCC in patients with chronic kidney disease （CKD）. Methods Two hundred and thirty two CKD patients were divided into 3 groups according to their Upro （Upro〈1. 5 g/24 h group, Upro 1.5-3.5 g/24 h group, Upro 〉3.5 g/24 h group） or serum albumin level （Salb〈25 g/L group, Salb 25-35 g/L group and Salb〉35 g/L group） respectively. Male ones of the 232 patients were also divided into 3 groups according to their Upro or Salb to test PSA and fPSA. Results The serum levels of CA125, CA153, CYFRA21-1, NSE and SCC in different Upro groups had significant statistical differences and also had positive correlations with Upro. There were no differences in CEA, CA199, AFP, CA724, PSA and fPSA among the 3 groups. CA125, CA199, CYFRA21-1, NSE and SCC in different Salb groups had significant differences and also had negative correlations with the level of serum albumin, but not the ease for CEA, CA153, AFP, CA724, PSA and fPSA. Conclusions In patients with heavy proteinuria or hypoalbuminemia, the specificity of some tumor markers for the diagnosis of the corresponding tumors is reduced.
出处
《复旦学报（医学版）》
CAS
CSCD
北大核心
2006年第3期305-308,314,共5页
Fudan University Journal of Medical Sciences
