Department of Laboratory Diagnostics, Changzheng Hospital, Second Military Medical University, Shanghai, China.
Clin Exp Rheumatol. 2012 Jan-Feb;30(1):93-8. Epub 2012 Mar 7.
Some studies have reported that serum CA125 level is elevated in SLE patients, and elevated CA125 level may be associated with kidney involvement and disease activity in SLE. However, none of the previous studies controlled confounding variables and the results remained controversial. The present study was aimed to investigate whether elevated serum CA125 level is independently associated with clinical and laboratory features of SLE by excluding various confounders in Chinese patients.
A total of 156 SLE patients, consisting of 139 women and 17 men, were included in the study. Some clinical and laboratory characteristics of the patients were obtained by medical record review. Serum CA125 levels were measured by electrochemiluminescence immunoassays.
Compared with patients with normal CA125, those with elevated CA125 had significantly more serositis (37.5% vs. 1.9%, p<0.001) and lung involvement (37.5% vs. 12%, p=<0.001), higher SLEDAI scores (p<0.007). Furthermore, disease duration was significantly longer in those with elevated CA125. Univariate logistic regression analysis showed that elevated serum CA125 level was closely associated with disease duration (OR, 95%CI:1.005, 1.001-1.010; p=0.014), serositis (OR, 95%CI: 32.258, 6.993-142.857; p<0.001), renal involvement (OR, 95%CI: 2.283, 1.114-4.673; p=0.024), lung involvement (OR, 95%CI: 4.386, 1.927-10.000; p<0.001) and SLEDAI scores (OR, 95%CI: 1.098, 1.027-1.174; p=0.006). After controlling for various confounding variables, serositis and disease duration were the only two clinical variables significantly associated with elevation of serum CA125 level. The best cut-off value for CA125 using the ROC curve was 38 kU/L (sensitivity 85%, specificity 75%) and the area under the ROC curve was 0.777 with 95%CI of 0.685-0.868 (p<0.001). Furthermore, the serum CA125 levels can fall into the normal range again with the improvement of serositis.
Of various clinical and laboratory variables of SLE, only serositis is independently associated with serum CA125 elevation.
一些研究报道系统性红斑狼疮（SLE）患者的血清 CA125 水平升高，且升高的 CA125 水平可能与 SLE 患者的肾脏受累和疾病活动度相关。然而，此前的研究均未控制混杂因素，结果仍存在争议。本研究旨在通过排除中国患者的各种混杂因素，探讨血清 CA125 水平升高是否与 SLE 的临床和实验室特征独立相关。
共纳入 156 例 SLE 患者，其中 139 例为女性，17 例为男性。通过病历回顾获取患者的部分临床和实验室特征。采用电化学发光免疫分析法检测血清 CA125 水平。
与 CA125 正常的患者相比，CA125 升高的患者更易发生浆膜炎（37.5% vs. 1.9%，p<0.001）和肺部受累（37.5% vs. 12%，p<0.001），SLEDAI 评分更高（p<0.007）。此外，CA125 升高的患者病程明显更长。单因素 logistic 回归分析显示，血清 CA125 水平升高与病程（OR，95%CI：1.005，1.001-1.010；p=0.014）、浆膜炎（OR，95%CI：32.258，6.993-142.857；p<0.001）、肾脏受累（OR，95%CI：2.283，1.114-4.673；p=0.024）、肺部受累（OR，95%CI：4.386，1.927-10.000；p<0.001）和 SLEDAI 评分（OR，95%CI：1.098，1.027-1.174；p=0.006）密切相关。排除混杂因素后，浆膜炎和病程是与血清 CA125 升高唯一相关的两个临床变量。ROC 曲线得出 CA125 的最佳截断值为 38 kU/L（灵敏度 85%，特异性 75%），ROC 曲线下面积为 0.777，95%CI 为 0.685-0.868（p<0.001）。此外，随着浆膜炎的改善，血清 CA125 水平可再次降至正常范围。
在 SLE 的各种临床和实验室变量中，只有浆膜炎与血清 CA125 升高独立相关。
