Department of Dermatology, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, China.
Rheumatology (Oxford). 2021 Aug 2;60(8):3896-3903. doi: 10.1093/rheumatology/keaa819.
The present study aimed to determine the correlation between serum carcinoembryonic antigen (CEA) level and the severity of interstitial lung disease (ILD) in clinically amyopathic DM (CADM) patients.
We performed a retrospective study including 41 Chinese CADM patients without malignancy. Serum CEA levels, clinical and laboratory findings were collected. Association tests between CEA levels and disease activity parameters were performed.
Among the 41 patients, 16 (39.0%) developed rapidly progressive (RP)-ILD; of them, 14 (87.5%) had elevated serum CEA levels. Multivariate logistic regression analysis indicated that an elevated serum CEA level was an independent risk factor for RP-ILD. The incidence of elevated CEA level was significantly higher in patients with RP-ILD than in those without RP-ILD (87.5 vs 16.0%, P < 0.001). Furthermore, CEA levels were higher in patients with CADM with RP-ILD [26.87 (6.71) μg/l] than in those without RP-ILD [3.23 (0.64) μg/l] (P < 0.001). CEA levels in CADM patients were associated with the ferritin, alanine aminotransferase, aspartate aminotransferase and lactate dehydrogenase levels, and CT scores of the lungs. Also, elevated CEA levels are related to the organizing pneumonia pattern and lower lung zone consolidation in high-resolution CT. Moreover, the cumulative survival rate was significantly lower (68.4 vs 31.6%, P < 0.001) in the group with a CEA level >8.75 μg/l than that in the group with a CEA level <8.75 μg/l.
An elevated serum CEA level is common in patients with CADM, and a higher serum CEA level is a powerful indicator of RP-ILD and poor prognosis in those patients.
本研究旨在确定血清癌胚抗原（CEA）水平与临床无肌病性皮肌炎（CADM）患者间质性肺病（ILD）严重程度之间的相关性。
我们进行了一项回顾性研究，纳入了 41 例无恶性肿瘤的中国 CADM 患者。收集血清 CEA 水平、临床和实验室检查结果。进行 CEA 水平与疾病活动参数之间的关联检验。
在 41 例患者中，16 例（39.0%）发生快速进展性（RP）-ILD；其中，14 例（87.5%）血清 CEA 水平升高。多变量 logistic 回归分析表明，血清 CEA 水平升高是 RP-ILD 的独立危险因素。RP-ILD 患者中 CEA 水平升高的发生率明显高于无 RP-ILD 患者（87.5%比 16.0%，P<0.001）。此外，RP-ILD 组 CADM 患者的 CEA 水平[26.87（6.71）μg/l]明显高于无 RP-ILD 组[3.23（0.64）μg/l]（P<0.001）。CADM 患者的 CEA 水平与铁蛋白、丙氨酸氨基转移酶、天冬氨酸氨基转移酶和乳酸脱氢酶水平以及肺部 CT 评分相关。此外，CEA 水平升高与高分辨率 CT 中的机化性肺炎模式和下肺区实变相关。而且，CEA 水平>8.75μg/l 组的累积生存率明显低于 CEA 水平<8.75μg/l 组（68.4%比 31.6%，P<0.001）。
CADM 患者中血清 CEA 水平升高较为常见，较高的血清 CEA 水平是这些患者发生 RP-ILD 和预后不良的有力指标。
