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系统性红斑狼疮中的肿瘤相关抗原:与临床表现和血清学指标的关联。

Tumour-associated antigens in systemic lupus erythematosus: association with clinical manifestations and serological indicators.

作者信息

Zhong Ying, Liu Zhichun, Ma Jinlu, Zhang Lin, Xue Leixi

机构信息

Department of Rheumatology and Immunology, The Second Affiliated Hospital of Soochow University, Suzhou, China.

出版信息

Rheumatology (Oxford). 2024 Jan 4;63(1):235-241. doi: 10.1093/rheumatology/kead224.

Abstract

OBJECTIVES

To explore the relationship of tumour-associated antigens (TAAs) with the clinical manifestations and serological markers of SLE.

METHODS

This was a retrospective study. Clinical data of SLE patients were extracted from the electronic medical records, including serum levels of TAAs such as alpha-fetoprotein (AFP), carcinoembryonic antigen (CEA), cancer antigen (CA) 19-9, CA125, CA15-3 and cytokeratin 19-fragments (CYFRA21-1). TAA positivity was defined as serum level exceeding the upper limit of the corresponding reference range.

RESULTS

A total of 149 SLE patients (SLE group) and 149 age- and sex-matched healthy subjects (control group) were enrolled. Compared with healthy controls, the SLE group had higher positivity rates for CA19-9 and CYFRA21-1, and elevated serum levels of CA125, CA15-3 and CYFRA21-1. SLE patients with TAA positivity were older, had a higher prevalence of serous effusion, pericardial effusion, albuminuria and thrombocytopenia, and lower positivity rate for anti-dsDNA than patients without TAA positivity. The levels of serum creatinine (SCR), blood urea nitrogen, glutamic oxalate transaminase and 24-h urinary protein were also higher in SLE patients with TAA positivity, but platelet count and serum albumin levels were lower. On logistic regression, thrombocytopenia and SCR levels were identified as independent risk factors for TAA positivity. CA125 positivity rate and serum levels of CA125 were associated with SLE disease activity.

CONCLUSION

The positivity rates and serum levels of some TAAs were elevated in SLE, and thrombocytopenia and SCR levels were independent risk factors for TAA positivity.

摘要

目的

探讨肿瘤相关抗原(TAA)与系统性红斑狼疮(SLE)临床表现和血清标志物的关系。

方法

这是一项回顾性研究。从电子病历中提取 SLE 患者的临床资料,包括甲胎蛋白(AFP)、癌胚抗原(CEA)、癌抗原 19-9(CA19-9)、CA125、CA15-3 和细胞角蛋白 19 片段(CYFRA21-1)等 TAA 的血清水平。TAA 阳性定义为血清水平超过相应参考范围的上限。

结果

共纳入 149 例 SLE 患者(SLE 组)和 149 名年龄和性别匹配的健康对照者(对照组)。与健康对照组相比,SLE 组 CA19-9 和 CYFRA21-1 的阳性率更高,CA125、CA15-3 和 CYFRA21-1 的血清水平也更高。TAA 阳性的 SLE 患者年龄更大,浆膜腔积液、心包积液、蛋白尿和血小板减少症的患病率更高,抗 dsDNA 的阳性率更低。TAA 阳性的 SLE 患者的血肌酐(SCR)、血尿素氮、草酰乙酸转氨酶和 24 小时尿蛋白水平也更高,但血小板计数和血清白蛋白水平更低。Logistic 回归分析显示,血小板减少症和 SCR 水平是 TAA 阳性的独立危险因素。CA125 阳性率和 CA125 血清水平与 SLE 疾病活动度相关。

结论

SLE 患者中某些 TAA 的阳性率和血清水平升高,血小板减少症和 SCR 水平是 TAA 阳性的独立危险因素。

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