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系统性红斑狼疮患者血清肿瘤标志物与浆液性积液的相关性

Association of serum tumor markers with serous effusion in systemic lupus erythematosus.

作者信息

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

机构信息

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

出版信息

Heliyon. 2023 Dec 3;9(12):e23213. doi: 10.1016/j.heliyon.2023.e23213. eCollection 2023 Dec.

Abstract

The objective of this study was to investigate the relationship between serum tumor markers and serous effusion in systemic lupus erythematosus (SLE) patients, thereby contributing preliminary data on the utility of these tumor markers in diagnosing serous effusion. In this retrospective analysis, clinical data of SLE patients were extracted from electronic medical records. This included the levels of serum tumor markers, including pro-gastrin-releasing peptide, neuron-specific enolase (NSE), cytokeratin-19 fragments (CYFRA 21-1), various carbohydrate antigens (CA 153, CA 125, CA 19-9), along with carcinoembryonic antigen, and alpha-fetoprotein. Positivity of tumor markers was established based on serum levels surpassing the upper threshold of the respective reference ranges. This study included 149 eligible patients with SLE, of whom 38 (25.50%) had serous effusion, and the prevalence of pleural, pericardial, and peritoneal effusions was 11.41%, 14.77%, and 6.71%, respectively. The analysis revealed that patients with serous effusion had higher scores on the SLE Disease Activity Index 2000 (SLEDAI 2000) than those without serous effusion. Notably, this disparity remained significant when the serositis score was excluded from the SLEDAI 2000 calculation. The positivity rate and serum levels of CA 125 were higher in patients with serous effusion and pleural effusion. Patients with pericardial effusion demonstrated an elevated CYFRA 21-1 positivity rate and serum CA 125 and CYFRA 21-1 levels compared to patients without pericardial effusion. CA 125 and NSE were higher both in terms of positivity rate and serum levels for patients with peritoneal effusion. Through receiver operating characteristic curve analysis, a moderate relationship was discerned between the conjoined levels of CYFRA 21-1 and CA 125 and the occurrence of pericardial effusion. Additionally, CA 125, NSE, and their combination revealed the moderate diagnostic ability of peritoneal effusion. In summary, this study observed elevated serum levels of various tumor markers in SLE patients exhibiting serous effusion, which is likely attributable to lupus-induced inflammation. These findings suggest that serum tumor markers can be valuable in diagnosing pericardial and peritoneal effusions.

摘要

本研究的目的是调查系统性红斑狼疮(SLE)患者血清肿瘤标志物与浆液性积液之间的关系,从而为这些肿瘤标志物在诊断浆液性积液中的应用提供初步数据。在这项回顾性分析中,从电子病历中提取了SLE患者的临床数据。这包括血清肿瘤标志物水平,包括胃泌素释放肽前体、神经元特异性烯醇化酶(NSE)、细胞角蛋白19片段(CYFRA 21-1)、各种糖类抗原(CA 153、CA 125、CA 19-9),以及癌胚抗原和甲胎蛋白。肿瘤标志物的阳性是根据血清水平超过各自参考范围的上限来确定的。本研究纳入了149例符合条件的SLE患者,其中38例(25.50%)有浆液性积液,胸腔、心包和腹腔积液的患病率分别为11.41%、14.77%和6.71%。分析显示,有浆液性积液的患者在2000年SLE疾病活动指数(SLEDAI 2000)上的得分高于无浆液性积液的患者。值得注意的是,当从SLEDAI 2000计算中排除浆膜炎得分时,这种差异仍然显著。有浆液性积液和胸腔积液的患者中,CA 125的阳性率和血清水平较高。与无心包积液的患者相比,有心包积液的患者CYFRA 21-1阳性率以及血清CA 125和CYFRA 21-1水平升高。腹腔积液患者的CA 125和NSE在阳性率和血清水平方面均较高。通过受试者工作特征曲线分析,发现CYFRA 21-1和CA 125的联合水平与心包积液的发生之间存在中等程度的关系。此外,CA 125、NSE及其组合显示出对腹腔积液有中等程度的诊断能力。总之,本研究观察到有浆液性积液的SLE患者血清中各种肿瘤标志物水平升高,这可能归因于狼疮诱导的炎症。这些发现表明血清肿瘤标志物在诊断心包和腹腔积液方面可能具有价值。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e220/10746481/eab69ebbebed/gr1.jpg

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