Zheng Muhan, Lou Aiju, Zhang Haoru, Zhu Shijie, Yang Min, Lai Weinan
Department of Rheumatology and Immunology, Nanfang Hospital, Southern Medical University, Guangzhou, Guangdong, China.
Department of Rheumatology and Immunology, Liwan Central Hospital of Guangzhou, Guangzhou, Guangdong, China.
Rheumatol Ther. 2021 Mar;8(1):517-527. doi: 10.1007/s40744-021-00288-x. Epub 2021 Feb 14.
This study aimed to evaluate the role of tumor marker carbohydrate antigen (CA) 125 (CA125), CA19-9, carcinoembryonic antigen (CEA) and Krebs von den Lungen-6 (KL-6) in the diagnosis and determination of the severity of interstitial lung disease (ILD) in rheumatoid arthritis (RA) patients.
A retrospective analysis was performed. Fifty RA patients (24 patients with ILD and 26 patients without ILD), 10 healthy subjects and 14 patients with other connective tissue disease-associated interstitial lung disease were included. Serum levels of KL-6 and tumor markers CA19-9, CA125 and CEA were measured. Chest HRCT of patients with ILD was scored quantitatively according to the degree of fibrosis. Data on the C-reactive protein, erythrocyte sedimentation rate, rheumatoid factors and anti-cyclic peptide containing citrulline (anti-CCP) were also collected.
Serum levels of KL-6, CA19-9, CA125 and CEA in the RA-ILD group were significantly higher than those in the RA-no-ILD group. The serum KL-6 level was positively correlated with the HRCT fibrosis score (r = 0.63, p = 0.002). The logistic regression analysis showed that CA19-9 and smoking were associated with RA-ILD [OR = 1.118, 95% CI = (1.038, 1.204), p = 0.003 for CA19-9, OR = 14.969, 95% CI = (1.750, 128.043), p = 0.013 for smoking].
KL-6 level and tumor markers were elevated in RA-ILD, and strongly associated with the severity of ILD, supporting their value as pathogenically relevant biomarkers, which can contribute to noninvasive detection of this extra-articular disease complication.
本研究旨在评估肿瘤标志物糖类抗原（CA）125（CA125）、CA19 - 9、癌胚抗原（CEA）和克雷伯氏肺6抗原（KL - 6）在类风湿关节炎（RA）患者间质性肺疾病（ILD）诊断及病情严重程度判定中的作用。
进行回顾性分析。纳入50例RA患者（24例有ILD，26例无ILD）、10例健康受试者及14例其他结缔组织病相关间质性肺疾病患者。检测血清KL - 6及肿瘤标志物CA19 - 9、CA125和CEA水平。对ILD患者的胸部高分辨率CT（HRCT）根据纤维化程度进行定量评分。还收集了C反应蛋白、红细胞沉降率、类风湿因子及抗环瓜氨酸肽（抗CCP）的数据。
RA - ILD组血清KL - 6、CA19 - 9、CA125和CEA水平显著高于RA - 无ILD组。血清KL - 6水平与HRCT纤维化评分呈正相关（r = 0.63，p = 0.002）。逻辑回归分析显示CA19 - 9和吸烟与RA - ILD相关[CA19 - 9的比值比（OR）= 1.118，95%可信区间（CI）=（1.038，1.204），p = 0.003；吸烟的OR = 14.969，95%CI =（1.750，128.043），p = 0.013]。
RA - ILD患者的KL - 6水平及肿瘤标志物升高，且与ILD严重程度密切相关，支持它们作为具有致病相关性生物标志物的价值，有助于对这种关节外疾病并发症进行无创检测。
