Honma Masaru, Nozaki Hiroyoshi, Nagahata Hiroko, Fujii Mizue, Shibuya Takashi, Kanno Kyoko, Minami-Hori Masako, Ishida-Yamamoto Akemi
Department of Dermatology, Asahikawa Medical University, Asahikawa, Japan.
J Dermatol. 2017 Aug;44(8):903-908. doi: 10.1111/1346-8138.13828. Epub 2017 Mar 11.
Anhidrosis/hypohidrosis are conditions presenting various level of sweating dysfunction. Among them, acquired idiopathic generalized anhidrosis (AIGA) presents inadequate decrease or loss of sweating without apparent neurological and dermatological symptoms except cholinergic urticaria. Recently, serum level of carcinoembryonic antigen (CEA), one of the most well-known tumor markers, has been proposed as a clinical marker reflecting activity of AIGA. This study was performed to verify the specificity and independence of serum CEA level from the other serum tumor markers especially related to adenocarcinoma. The expression of various tumor markers in the serum collected from three healthy control subjects, four AIGA cases, and a cholinergic urticaria (CU) case with elevation of serum CEA level and history of hyperthermia was analyzed using a membrane-based antibody array. In all AIGA and CU cases, the intensity of CEA was significantly increased (7.60-15.9 times compared with that of control), relatively well-reflecting the serum CEA level, and the mean intensity of CEA was 11.8 times higher than the control subjects (P = 0.0011). On the other hand, the ratio of carbohydrate antigen (CA)125 and CA19-9 was 1.93 and 0.23 times compared with the mean intensity of the control subjects, respectively, and there was no statistical significance. Immunohistochemistry on 10 AIGA cases showed increased expression of CEA but not CA19-9 and CA125 in the eccrine sweat glands. In conclusion, the elevation of serum CEA level was independent from the other tumor markers in hypohidrotic condition represented by AIGA.
无汗症/少汗症是表现出不同程度出汗功能障碍的病症。其中,获得性特发性全身无汗症(AIGA)表现为出汗减少或丧失不足,除胆碱能性荨麻疹外无明显神经和皮肤症状。最近,癌胚抗原(CEA)作为最著名的肿瘤标志物之一,其血清水平已被提议作为反映AIGA活性的临床标志物。本研究旨在验证血清CEA水平相对于其他血清肿瘤标志物,尤其是与腺癌相关的标志物的特异性和独立性。使用基于膜的抗体阵列分析了从三名健康对照受试者、四名AIGA病例以及一名血清CEA水平升高且有高热病史的胆碱能性荨麻疹(CU)病例采集的血清中各种肿瘤标志物的表达。在所有AIGA和CU病例中,CEA的强度显著增加(与对照组相比为7.60 - 15.9倍),相对较好地反映了血清CEA水平,CEA的平均强度比对照受试者高11.8倍(P = 0.0011)。另一方面,糖类抗原(CA)125和CA19 - 9的比值分别为对照受试者平均强度的1.93倍和0.23倍,无统计学意义。对10例AIGA病例进行免疫组织化学检测显示,外分泌汗腺中CEA表达增加,但CA19 - 9和CA125未增加。总之,在以AIGA为代表的少汗症情况下,血清CEA水平的升高独立于其他肿瘤标志物。