Nakayama Mika, Satoh Hiroaki, Ishikawa Hiroichi, Fujiwara Masachika, Kamma Hiroshi, Ohtsuka Morio, Sekizawa Kiyohisa
Division of Respiratory Medicine, Institute of Clinical Medicine, University of Tsukuba, Ibaraki, Japan.
Chest. 2003 Jun;123(6):2001-6. doi: 10.1378/chest.123.6.2001.
Cytokeratin 19 fragment (CYFRA) is a specific tumor marker in patients with lung cancer; however, it has been reported that serum CYFRA levels are elevated in some patients with nonmalignant respiratory diseases such as interstitial pulmonary fibrosis (IPF) and collagen disease-associated pulmonary fibrosis (CDPF). To investigate the serum CYFRA levels in nonmalignant respiratory diseases in detail, we studied 413 patients with respiratory diseases.
Retrospective study.
University hospital.
Four hundred thirteen patients with nonmalignant respiratory diseases and lung cancer.
Serum CYFRA levels were measured with a commercially available enzyme immunoassay kit. Immunohistochemical study was performed using monoclonal antibody Ks 19.1 (Rosch Diagnosica; Bern, Switzerland) on surgically resected or autopsied lung specimens. Gel electrophoresis and immunoblotting was performed with serum samples. In 149 patients with nonmalignant diseases except IPF and CDPF, the ratio of patients with > 3.5 ng/mL of serum CYFRA was 13.4%. In 13 of 30 patients (43.3%) with IPF and CDPF, the serum CYFRA levels were abnormally elevated. The 95th percentile serum CYFRA level of the patients with nonmalignant respiratory diseases was 6.2 ng/mL, and none of them had CYFRA levels > 20.3 ng/mL. Survival in patients with IPF and CDPF with elevated serum CYFRA levels were significantly lower than in those with normal range (p = 0.0335). Western blotting using serum from nonmalignant lung diseases and patients with lung cancer showed no apparent difference between them. An immunohistochemical study indicated CYFRA was selectively expressed in the pulmonary epithelial cells that covered the remodeling alveolar septi in nonmalignant respiratory disease.
Serum CYFRA was elevated in some nonmalignant respiratory diseases, especially in IPF and CDPF. The value of serum CYFRA would reflect the severity of lung injury in nonmalignant respiratory diseases and might be related to the prognosis in patients with IPF and CDPF.
细胞角蛋白19片段（CYFRA）是肺癌患者的一种特异性肿瘤标志物；然而，据报道，在一些患有非恶性呼吸系统疾病（如间质性肺纤维化（IPF）和胶原病相关肺纤维化（CDPF））的患者中，血清CYFRA水平会升高。为了详细研究非恶性呼吸系统疾病患者的血清CYFRA水平，我们对413例呼吸系统疾病患者进行了研究。
回顾性研究。
大学医院。
413例患有非恶性呼吸系统疾病和肺癌的患者。
使用市售酶免疫分析试剂盒测量血清CYFRA水平。对手术切除或尸检的肺标本使用单克隆抗体Ks 19.1（Rosch Diagnosica；瑞士伯尔尼）进行免疫组织化学研究。对血清样本进行凝胶电泳和免疫印迹分析。在149例除IPF和CDPF外的非恶性疾病患者中，血清CYFRA>3.5 ng/mL的患者比例为13.4%。在30例IPF和CDPF患者中有13例（43.3%）血清CYFRA水平异常升高。非恶性呼吸系统疾病患者血清CYFRA水平的第95百分位数为6.2 ng/mL，且他们中没有人的CYFRA水平>20.3 ng/mL。血清CYFRA水平升高的IPF和CDPF患者的生存率显著低于水平正常者（p = 0.0335）。使用非恶性肺部疾病患者和肺癌患者的血清进行的蛋白质印迹分析显示两者之间无明显差异。免疫组织化学研究表明，CYFRA在非恶性呼吸系统疾病中覆盖重塑肺泡间隔的肺上皮细胞中选择性表达。
血清CYFRA在一些非恶性呼吸系统疾病中升高，尤其是在IPF和CDPF中。血清CYFRA的值可能反映非恶性呼吸系统疾病中肺损伤的严重程度，并且可能与IPF和CDPF患者的预后有关。
