Division of Cardiovascular and Respiratory Studies, University of Hull, Castle Hill Hospital, Cottingham, UK.
Respirology. 2012 Nov;17(8):1247-52. doi: 10.1111/j.1440-1843.2012.02231.x.
Idiopathic pulmonary fibrosis (IPF) is the commonest idiopathic interstitial pneumonia and carries a poor prognosis. Epidemiological evidence suggests that patients with IPF have an increased risk of developing lung cancer. Carcinoembryonic antigen (CEA) has a close association with epithelial malignancy. The aim of this study was to evaluate serum CEA concentrations in patients with IPF and to perform correlation with pulmonary function.
Serum CEA concentrations were measured by two-site sequential chemiluminescent immunometric assay in 41 non-smoking patients with IPF. Patients with a history of gastrointestinal tract malignancy or other disorder known to be associated with raised serum CEA were excluded.
A total of 41 patients were evaluated. The mean (±standard deviation) age of patients was 73 ± 7 years. The mean (±standard deviation) forced vital capacity was 88 ± 20% of predicted, and the mean (±standard deviation) diffusing factor for carbon monoxide (DLco) was 52 ± 19% of predicted. Twenty-one (51%) patients had a serum CEA concentration higher than upper limit of the normal range (0-5 ng/mL). CEA concentration was significantly negatively correlated with lung function (P = 0.005; R(2) = 0.20 for forced vital capacity and P = 0.006; R(2) = 0.20 for DLco). Raised CEA level also correlated significantly with the extent of fibrosis. A lung biopsy specimen from a patient with IPF demonstrated strong staining for CEA in metaplastic epithelium lining the honeycombed cysts and respiratory bronchioles.
Serum CEA concentration is elevated in approximately half of patients with IPF and is correlated with disease severity. Immunohistochemical staining reveals that CEA localizes to metaplastic epithelium lining honeycombed bronchioles.
特发性肺纤维化（IPF）是最常见的特发性间质性肺炎，预后较差。流行病学证据表明，IPF 患者发生肺癌的风险增加。癌胚抗原（CEA）与上皮恶性肿瘤密切相关。本研究旨在评估 IPF 患者的血清 CEA 浓度，并与肺功能进行相关性分析。
采用双位点序贯化学发光免疫分析测定 41 例非吸烟 IPF 患者的血清 CEA 浓度。排除有胃肠道恶性肿瘤病史或其他已知与血清 CEA 升高相关的疾病的患者。
共评估了 41 例患者。患者的平均（±标准差）年龄为 73±7 岁。平均（±标准差）用力肺活量为预计值的 88±20%，平均（±标准差）一氧化碳弥散量（DLco）为预计值的 52±19%。21 例（51%）患者的血清 CEA 浓度高于正常范围上限（0-5ng/mL）。CEA 浓度与肺功能显著负相关（P=0.005；R²=0.20 用于用力肺活量，P=0.006；R²=0.20 用于 DLco）。升高的 CEA 水平也与纤维化程度显著相关。一名 IPF 患者的肺活检标本显示，蜂窝状囊泡和呼吸性细支气管衬里的化生上皮中 CEA 染色强烈。
约一半的 IPF 患者血清 CEA 浓度升高，与疾病严重程度相关。免疫组织化学染色显示 CEA 定位于蜂窝状细支气管衬里的化生上皮。
