摘要
目的 探讨肿瘤标志物在类风湿性关节炎伴间质性肺病（RA-ILD）中的临床意义.方法 收集2008年1月至2011年1月住院的82例类风湿关节炎患者.根据是否伴有间质性肺病,将其分为RA-ILD组（38例）和RA组（44例）,比较两组血清肿瘤标志物癌胚抗原（CEA）、糖蛋白抗原15-3（CA15-3）、糖蛋白抗原19-9（CA19-9）水平、抗环瓜氨酸肽（CCP）抗体水平和肺功能包括用力肺活量（FVC）、第1秒用力呼气量（FEV1）、一氧化碳弥散量（DL）占预计值百分比,分析两组患者肿瘤标志物表达差异以及RA-ILD组肿瘤标志物与肺功能、抗CCP抗体相关性.结果 RA-ILD组外周血CEA、CA15-3、CA19-9水平均明显高于RA组（均P＜0.01）;RA-ILD组FVC、FEV1和DLco占预计值百分比均明显低于RA组（均P＜0.01）,但RA-ILD组抗CCP抗体水平与RA组比较差异无统计学意义（P ＞0.05）.RA-ILD组CEA水平与FVC、FEV1和DLco呈负相关（r=-0.499、-0.576、-0.512,均P＜0.01）,但CEA、CA15-3和CA19-9均与抗CCP抗体无相关性（r=-0.192、-0.264、-0.268,均P ＞0.05）.结论 肿瘤标志物CEA、CA15-3和CA19-9在RA-ILD中表达升高,CEA可能反应RA-ILD肺间质受损的严重程度,而不是关节损害的严重程度.
Objective To assess the clinical significance of tumor markers （TMs） in rheumatoid arthritis （RA） with interstitial lung diseases （ILD）. Methods Eighty-two RA inpatients were admitted in Hangzhou First People＇s Hospital from January 2008 to January 2011; among whom 38 were complicated by interstitial lung diseases （RA-ILD）. Tumor markers （CEA, CA15-3, CA19-9）, pulmonary function indexes （FVC, FEV1, DLco） and anti-cyclic citrullinated peptide antibody （anti-CCP） levels were measured in all patients. Correlation between TMs and pulmonary function indexes, level of anti-CCP antibody was analyzed by Spearman rank correlation. Results Serum levels of CEA, CA15-3 and CA19-9 in RA-ILD group were significantly higher than those in RA group （P〈0.01）. The percentage of predicted value for FVC, FEV1 and DLco was significantly decreased in RA-ILD group than that in RA group （P〈0.01）. There was no significant difference in anti-CCP levels between two groups （ P 〉0.05）. Serum CEA level was negatively correlated with FVC （r=-0.499, P〈0.01）, FEVl（r=-0.576, P〈0.01） and DLco （r=-0.512, P〈0.01） in RA-ILD patients. There were no correlation of CEA, CA15-3 and CA19-9 levels with anti-CCP antibody （ r=-0.192, -0.264, -0.268,respectively, P 〉0.05）. Conclusion The serum tumor marker （CEA, CA15-3 and CA19-9） levels are increased in RA-ILD. CEA levels may reflect the decrease of lung function in RA-ILD, not the severity of joint lesion.
出处
《浙江医学》
CAS
2012年第12期984-985,989,共3页
Zhejiang Medical Journal
