Dai Huaping, Liu Jianqun, Liang Lirong, Ban Chengjun, Jiang Jing, Liu Yan, Ye Qiao, Wang Chen
Department of Respiratory and Critical Care Medicine, Beijing Chao-Yang Hospital, Capital Medical University, Beijing, China; Beijing Key Laboratory of Respiratory and Pulmonary Circulation Disorders, Beijing Institute of Respiratory Medicine, Beijing, China.
Respirology. 2014 Jul;19(5):707-13. doi: 10.1111/resp.12317. Epub 2014 Jun 5.
BACKGROUND AND OBJECTIVE: The aetiology and pathogenesis of interstitial lung disease (ILD) and ILD combined with lung cancer (ILD-CA) are unclear. We aim to investigate serum tumour marker (STM) levels and to explore their predictive and diagnostic value of cancer in ILD. METHODS: Fifty-eight patients with ILD-CA, 632 with ILD only and 628 with acute respiratory illness were studied. Serum levels of carcinoembryonic antigen (CEA), carbohydrate antigen 19-9 (CA19-9), CA125 and neuron-specific enolase (NSE) were measured. RESULTS: All STM levels were elevated in ILD-CA compared with ILD group (P < 0.01). CEA and CA125 levels were significantly higher in ILD than in controls (P < 0.01). After adjustment for gender, age and smoking, ILD-CA risk in the CEA and CA125 fourth quartiles was increased compared with the first quartiles (CEA: odds ratio (OR) = 8.7, 95% confidence interval (CI) = 2.0-37.6; CA125: OR = 9.8, 95% CI = 2.3-42.7). Receiver operating characteristic (ROC) curve analysis in patients with ILD-CA showed a cut-off points of 3.99 ng/mL for CEA and 35.00 U/mL for CA125 with sensitivities of 74.6% and 71.9%, specificities 70.4% and 66.1%, and the areas under the curve 0.76 (95% CI = 0.69-0.82) and 0.75 (95% CI = 0.69-0.81), respectively. CONCLUSIONS: Serum CEA and CA125 levels are often elevated in ILD patients. The risk of cancer in ILD is increased with an elevation of serum CEA and CA125 levels. Serum CEA and CA125 levels may be a marker of cancer in ILD patients.
背景与目的：间质性肺疾病（ILD）及ILD合并肺癌（ILD-CA）的病因及发病机制尚不清楚。我们旨在研究血清肿瘤标志物（STM）水平，并探讨其对ILD患者癌症的预测和诊断价值。 方法：对58例ILD-CA患者、632例单纯ILD患者和628例急性呼吸道疾病患者进行研究。检测血清癌胚抗原（CEA）、糖类抗原19-9（CA19-9）、CA125和神经元特异性烯醇化酶（NSE）水平。 结果：与ILD组相比，ILD-CA患者所有STM水平均升高（P<0.01）。ILD患者的CEA和CA125水平显著高于对照组（P<0.01）。在调整性别、年龄和吸烟因素后，CEA和CA125第四四分位数的ILD-CA风险比第一四分位数增加（CEA：比值比（OR）=8.7，95%置信区间（CI）=2.0-37.6；CA125：OR=9.8，95%CI=2.3-42.7）。对ILD-CA患者进行的受试者工作特征（ROC）曲线分析显示，CEA的截断点为3.99 ng/mL，CA125为35.00 U/mL，敏感性分别为74.6%和71.9%，特异性分别为70.4%和66.1%，曲线下面积分别为0.76（95%CI=0.69-0.82）和0.75（95%CI=0.69-0.81）。 结论：ILD患者血清CEA和CA125水平常升高。血清CEA和CA125水平升高会增加ILD患者患癌风险。血清CEA和CA125水平可能是ILD患者患癌的一个标志物。
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