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碳水化合物抗原 15-3 作为慢性变应性肺炎患者疾病严重程度的标志物。

Carbohydrate antigen 15-3 as a marker of disease severity in patients with chronic hypersensitivity pneumonitis.

机构信息

. Disciplina de Pneumologia, Universidade Federal de São Paulo - UNIFESP - São Paulo (SP) Brasil.

. Departamento de Radiologia, Grupo Fleury, São Paulo (SP) Brasil.

出版信息

J Bras Pneumol. 2021 Mar 8;47(1):e20200589. doi: 10.36416/1806-3756/e20200589. eCollection 2021.

Abstract

OBJECTIVE

Biomarkers associated with mucin 1, such as Krebs von den Lungen-6 and carbohydrate antigen (CA) 15-3, are increased in various interstitial lung diseases. Our aim was to determine whether CA 15-3 could be considered a biomarker of disease severity in patients with chronic hypersensitivity pneumonitis (cHP).

METHODS

This was a prospective observational study involving adult patients with cHP. Serum levels of CA 15-3 were measured and were correlated with variables related to disease severity and extension. HRCT scans were quantitatively analyzed using a computational platform and an image analysis tool (Computer Aided Lung Informatics for Pathology Evaluation and Rating). CA 15-3 levels were normalized by logarithmic transformation.

RESULTS

The sample comprised 41 patients. The mean age of the patients was 60.1 ± 11.6 years. The mean FVC in % of predicted was 70.3% ± 17.3%, and the median of the serum level of CA 15-3 was 48.1 U/mL. CA 15-3 levels inversely correlated with FVC in % of predicted (r = -0,30; p = 0,05), DLCO in % of predicted (r = -0,54; p < 0,01), and SpO2 at the end of a 4-min step test (r = -0,59; p < 0,01), but they directly correlated with total quantitative HRCT scores (r = 0,47; p = 0,004), especially regarding ground-glass opacities (r = 0.58; p < 0,001).

CONCLUSIONS

CA 15-3 is likely to be a biomarker of disease severity of patients with cHP, particularly regarding gas exchange abnormalities.

摘要

目的

与 MUC1 相关的生物标志物,如 Krebs von den Lungen-6 和糖类抗原(CA)15-3,在各种间质性肺疾病中增加。我们的目的是确定 CA 15-3 是否可以被认为是慢性过敏性肺炎(cHP)患者疾病严重程度的生物标志物。

方法

这是一项涉及成人 cHP 患者的前瞻性观察研究。测量了血清 CA 15-3 水平,并将其与与疾病严重程度和扩展相关的变量相关联。使用计算平台和图像分析工具(计算机辅助肺病理学评估和分级)对 HRCT 扫描进行定量分析。通过对数转换使 CA 15-3 水平标准化。

结果

该样本包括 41 名患者。患者的平均年龄为 60.1±11.6 岁。预测 FVC 的平均值为 70.3%±17.3%,血清 CA 15-3 的中位数为 48.1 U/mL。CA 15-3 水平与预测 FVC 的百分比呈负相关(r=-0.30;p=0.05),与预测 DLCO 的百分比呈负相关(r=-0.54;p<0.01),与 4 分钟台阶试验结束时的 SpO2 呈负相关(r=-0.59;p<0.01),但与总定量 HRCT 评分呈正相关(r=0.47;p=0.004),特别是与磨玻璃影(r=0.58;p<0.001)。

结论

CA 15-3 可能是 cHP 患者疾病严重程度的生物标志物,特别是在气体交换异常方面。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2a22/8332669/ba6a52f35af7/1806-3756-jbpneu-47-01-e20200589-gf1.jpg

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