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评估血清肿瘤标志物在间质性肺炎患者肺癌检测中的诊断效用。

Assessing the diagnostic utility of serum tumor markers for lung cancer detection in patients with interstitial pneumonia.

作者信息

Chen Lulu

机构信息

People' Hospital Affiliated to Fujian University of Traditional Chinese Medicine, 817 Middle Road 602, Taijiang District, Fuzhou, Fujian Province, China.

出版信息

Clin Transl Oncol. 2025 Feb;27(2):486-493. doi: 10.1007/s12094-024-03638-7. Epub 2024 Aug 2.

Abstract

BACKGROUND

The prevalence of lung cancer among individuals afflicted with interstitial pneumonia (IP) stands at approximately 20%. The early detection of lung cancer via chest computed tomography (CT) surveillance proves challenging in IP patients. Our investigation sought to identify a potential biomarker capable of providing early indications of the presence of lung tumors in such patients.

MATERIALS AND METHODS

We examined the attributes of serum tumor markers, imaging characteristics, and histological findings in individuals diagnosed with IP, both with and without concurrent lung cancer.

RESULTS

106 patients diagnosed with IP were included in the study, comprising 36 individuals with concurrent lung cancer and 70 patients solely diagnosed with IP. Serum concentrations of CEA and CA12-5 were notably elevated in IP patients with lung cancer, compared to those with IP alone. Logistic regression analyses revealed that, in comparison to IP patients within the first quartile of CEA levels, the relative risk of developing lung cancer associated with IP escalated by 4.0-fold, 3.1-fold, 11.0-fold, and 13.3-fold in the second, third, fourth, and fifth quartiles, respectively. Upon controlling for gender and age, statistical significance in risk was observed solely for the fourth and fifth quartiles. Receiver operating characteristic (ROC) curve analysis conducted in patients diagnosed with ILD-CA identified a CEA cutoff point of 6.9 ng/mL, demonstrating sensitivities of 61.1% and specificities of 78.5%. The area under the curve was calculated as 0.7(95% CI: 0.63-0.81).

CONCLUSION

The serum levels of CEA were notably elevated in IP patients with concurrent lung cancer in contrast to those who were just suffering from IP. The heightened serum CEA levels correlate with an escalated risk of cancer occurrence among IP patients, suggesting that serum CEA levels could potentially serve as an indicative marker for the presence of cancer in IP patients.

摘要

背景

间质性肺炎(IP)患者中肺癌的患病率约为20%。通过胸部计算机断层扫描(CT)监测早期发现肺癌在IP患者中具有挑战性。我们的研究旨在确定一种潜在的生物标志物,能够为此类患者中肺部肿瘤的存在提供早期迹象。

材料与方法

我们检查了诊断为IP的患者(无论是否并发肺癌)的血清肿瘤标志物特征、影像学特征和组织学发现。

结果

106例诊断为IP的患者纳入研究,其中36例并发肺癌,70例仅诊断为IP。与单纯IP患者相比,并发肺癌的IP患者血清CEA和CA12-5浓度显著升高。逻辑回归分析显示,与CEA水平处于第一四分位数的IP患者相比,CEA水平处于第二、第三、第四和第五四分位数的IP患者发生肺癌的相对风险分别升高了4.0倍、3.1倍、11.0倍和13.3倍。在控制性别和年龄后,仅第四和第五四分位数的风险具有统计学意义。在诊断为ILD-CA的患者中进行的受试者操作特征(ROC)曲线分析确定CEA截断点为6.9 ng/mL,灵敏度为61.1%,特异性为78.5%。曲线下面积计算为0.7(95%CI:0.63-0.81)。

结论

与单纯患有IP的患者相比,并发肺癌的IP患者血清CEA水平显著升高。血清CEA水平升高与IP患者癌症发生风险增加相关,表明血清CEA水平可能作为IP患者癌症存在的指示性标志物。

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