Cancer Department, Daping Hospital, Army Medical University, No. 10 Changjiang Zhi Road, Daping Yuzhong District, Chongqing, 400042, China.
Sci Rep. 2021 Sep 24;11(1):19044. doi: 10.1038/s41598-021-98513-8.
Carcinoembryonic antigen (CEA) is not only used to aid the diagnosis of lung cancer, but also help monitor recurrence and determine the prognosis of lung cancer as well as evaluate the therapeutic efficacy for lung cancer. However, studies have also shown that CEA is present at low levels in the serum of patients with benign lung diseases (BLD), which will interfere with the accurate judgment of the disease. Due to difference in sample size, detection methods, cutoff values and sources of BLD, the positive rate of CEA in BLD is different with different literature. Therefore, it is necessary to define CEA levels in patients of different BLD in a large sample study. 4796 patients with BLD were included in this study. The results showed that the CEA levels of 3.1% (149/4796) patients with BLD were elevated, with three cases exceeds 20 ng/mL (0.06%, 3/4796). The results from the literature showed that BLD had a mean positive rate of 5.99% (53/885) and only two cases had CEA above 20 ng/mL. The CEA elevations mainly distributed in chronic obstructive pulmonary disease (COPD), pneumonitis and interstitial lung disease and significantly correlated with age of patients (OR 2.69, 95% CI 1.94-3.73, p < 0.001). Pulmonary tuberculosis (7/1311, 0.53%) had the lowest positive rate of CEA elevations while pulmonary alveolar proteinosis (6/27, 22.22%) had the highest positive rate. The majority of patients with abnormally elevated CEA levels had multiple underlying diseases, mainly diseases of the circulatory system (42.28% [63/149]), endocrine diseases (26.85% [40/149]), and respiratory or heart failure (24.16% [36/149]. In endocrine diseases, 87.5% (35/40) of patients had diabetes. In conclusion, CEA is present at a low positive rate in the serum of patients with BLD, but few exceed 20 ng/mL. For lung disease patients, if CEA levels rise, we should carry out comprehensive analysis of types of lung diseases, age of patients, and comorbid diseases.
癌胚抗原（CEA）不仅用于辅助肺癌的诊断，还可帮助监测复发情况，确定肺癌的预后，并评估肺癌的治疗效果。然而，研究也表明，良性肺部疾病（BLD）患者血清中的 CEA 水平较低，这会干扰对疾病的准确判断。由于样本量、检测方法、截断值和 BLD 来源的不同，不同文献中 CEA 在 BLD 中的阳性率也不同。因此，有必要在大样本研究中定义不同 BLD 患者的 CEA 水平。本研究纳入了 4796 例 BLD 患者。结果显示，3.1%（149/4796）的 BLD 患者 CEA 水平升高，其中 3 例超过 20 ng/mL（0.06%，3/4796）。文献结果显示，BLD 的平均阳性率为 5.99%（53/885），仅 2 例 CEA 超过 20 ng/mL。CEA 升高主要分布在慢性阻塞性肺疾病（COPD）、肺炎和间质性肺疾病中，且与患者年龄显著相关（OR 2.69，95%CI 1.94-3.73，p<0.001）。肺结核（7/1311，0.53%）的 CEA 升高阳性率最低，而肺泡蛋白沉积症（6/27，22.22%）的阳性率最高。大多数 CEA 水平异常升高的患者有多种基础疾病，主要是循环系统疾病（42.28%[63/149]）、内分泌疾病（26.85%[40/149]）和呼吸或心力衰竭（24.16%[36/149]）。在内分泌疾病中，87.5%（35/40）的患者患有糖尿病。总之，BLD 患者血清中 CEA 的阳性率较低，但很少超过 20 ng/mL。对于肺部疾病患者，如果 CEA 水平升高，我们应综合分析肺部疾病类型、患者年龄和合并症。
