Sah Renu, Muthu Valliappan, Kamboj Parul, Pal Arnab, Rudramurthy Shivaprakash M, Dhooria Sahajal, Sehgal Inderpaul Singh, Prasad Kuruswamy Thurai, Garg Mandeep, Aggarwal Ashutosh N, Agarwal Ritesh
Department of Internal Medicine, Postgraduate Institute of Medical Education and Research (PGIMER), Chandigarh, India.
Department of Pulmonary Medicine, Postgraduate Institute of Medical Education and Research (PGIMER), Chandigarh, India.
Lung India. 2025 Jul 1;42(4):309-314. doi: 10.4103/lungindia.lungindia_32_25. Epub 2025 Jun 27.
Serum periostin and carcinoembryonic antigen (CEA) are markers of type 2 inflammation. However, their role in diagnosing and monitoring treatment responses in allergic bronchopulmonary aspergillosis (ABPA) remains uncertain. The objective of the study was to assess the diagnostic performance of serum CEA and periostin in distinguishing ABPA from asthma. We also evaluate their usefulness in monitoring treatment responses.
We enrolled consecutive subjects with ABPA (cases) and asthmatic patients without ABPA (controls). Serum periostin and CEA levels were measured at baseline and again 2 months after oral prednisolone. We constructed receiver operating characteristic (ROC) curves and determined sensitivity and specificity using the optimal cut-off derived from Youden's index.
We enrolled 112 and 108 subjects with ABPA and asthma (median age: 34 years) respectively. At baseline, the median serum periostin (22.03 vs 16.36 ng/mL; P < 0.001) and CEA levels (4.80 vs 2.35 ng/mL; P < 0.001) were significantly higher in the ABPA group than in the controls. CEA (AUROC = 0.77) showed better diagnostic accuracy than serum periostin (AUROC = 0.64) in differentiating asthma from ABPA. After 2 months of treatment, median serum CEA (4.8 ng/mL vs 3.7 ng/mL) and periostin levels (22.03 vs 17.74 ng/mL) declined significantly. However, 34% and 30% of subjects exhibited increased periostin and CEA levels following treatment.
While serum CEA and periostin exhibit modest diagnostic performance in differentiating ABPA from asthma, they are suboptimal for monitoring treatment responses. Further studies are required to validate our findings.
血清骨膜蛋白和癌胚抗原（CEA）是2型炎症的标志物。然而，它们在过敏性支气管肺曲霉病（ABPA）的诊断和治疗反应监测中的作用仍不明确。本研究的目的是评估血清CEA和骨膜蛋白在区分ABPA与哮喘方面的诊断性能。我们还评估了它们在监测治疗反应中的有用性。
我们纳入了连续的ABPA患者（病例组）和无ABPA的哮喘患者（对照组）。在基线时以及口服泼尼松龙2个月后再次测量血清骨膜蛋白和CEA水平。我们构建了受试者工作特征（ROC）曲线，并使用约登指数得出的最佳临界值确定敏感性和特异性。
我们分别纳入了112例ABPA患者和108例哮喘患者（中位年龄：34岁）。在基线时，ABPA组的血清骨膜蛋白中位数（22.03对16.36 ng/mL；P<0.001）和CEA水平（4.80对2.35 ng/mL；P<0.001）显著高于对照组。在区分哮喘与ABPA方面，CEA（曲线下面积=0.77）比血清骨膜蛋白（曲线下面积=0.64）显示出更好的诊断准确性。治疗2个月后，血清CEA中位数（4.8 ng/mL对3.7 ng/mL）和骨膜蛋白水平（从22.03 ng/mL降至17.74 ng/mL）显著下降。然而，34%和30%的受试者在治疗后骨膜蛋白和CEA水平升高。
虽然血清CEA和骨膜蛋白在区分ABPA与哮喘方面表现出一定的诊断性能，但它们在监测治疗反应方面并不理想。需要进一步研究来验证我们的发现。
