肿瘤标志物在孤立性非自愿体重减轻患者鉴别诊断中的应用。
Tumour Markers in the Differential Diagnosis of Patients With Isolated Involuntary Weight Loss.
机构信息
Laboratory Medicine Althaia, Xarxa Assistencial Universitària de Manresa, Manresa, Spain;
Faculty of Medicine, Universitat de Vic, Universitat Central de Catalunya, Vic, Spain.
出版信息
In Vivo. 2021 Nov-Dec;35(6):3361-3367. doi: 10.21873/invivo.12634.
BACKGROUND/AIM: Paraneoplastic syndrome symptoms include isolated involuntary weight loss (IIWL). The differential diagnosis of cancer from other diseases may require a significant number of tests. Tumour markers (TMs) can be used for the diagnosis and stratification of patients according to cancer risk.
PATIENTS AND METHODS
This study included 606 patients (48% females) seen at the rapid diagnostic unit for IIWL. We determined the levels of TMs carcinoembryonic antigen, carbohydrate antigen 19-9, soluble fragments of cytokeratin 19, carbohydrate antigen 15-3, carbohydrate antigen 125, neuron specific enolase, alpha-fetoprotein, prostatic specific antigen using the multiparametric analyser COBAS 601. Two cut-off points were established, the upper reference limit described by the manufacturer and a high cut-off point suggested by Molina et al., to stratify patients according to cancer risk.
RESULTS
Patients were classified according to TM levels as follows: I) all TMs below the upper reference limit; II) highest number of TMs between the two cut-offs; III) at least one TM above the higher cut-off. The odds ratio for malignancy was 4.3 for group II and 248 for group III. These results indicate that when at least one TM is above the higher cut-off, neoplasia is highly probable.
CONCLUSION
TM determination allowed to establish cancer risk in patients with IIWL.
背景/目的：副肿瘤综合征的症状包括孤立性非自愿体重减轻（IIWL）。癌症与其他疾病的鉴别诊断可能需要进行大量的检查。肿瘤标志物（TMs）可用于诊断和根据癌症风险对患者进行分层。
患者和方法
本研究纳入了 606 名（48%为女性）在快速诊断单位就诊的 IIWL 患者。我们使用 COBAS 601 多参数分析仪测定了癌胚抗原、糖抗原 19-9、细胞角蛋白 19 的可溶性片段、糖抗原 15-3、糖抗原 125、神经元特异性烯醇化酶、甲胎蛋白、前列腺特异性抗原等 TMs 的水平。我们设定了两个截断值，即制造商描述的上限参考值和 Molina 等人建议的高截断值，以根据癌症风险对患者进行分层。
结果
根据 TM 水平，患者被分类如下：I）所有 TMs 均低于上限参考值；II）两个截断值之间的 TM 数量最高；III）至少有一个 TM 高于较高的截断值。组 II 的恶性肿瘤比值比为 4.3，组 III 的比值比为 248。这些结果表明，当至少一个 TM 高于较高的截断值时，肿瘤的可能性非常高。
结论
TM 测定可确定 IIWL 患者的癌症风险。
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