Ichiki H, Shishido M, Nishitani K, Takatsugi K, Nishiyama S, Yano M, Watanabe K
Department of Internal Medicine, Ehime Prefectural Niihama Hospital, Japan.
Nihon Kyobu Shikkan Gakkai Zasshi. 1993 Dec;31(12):1522-7.
Serum tumor markers (CEA, SLX, CA125) were evaluated in 123 patients with active pulmonary tuberculosis. The results were as follows: Elevated serum CEA, SLX and CA125 levels were found in 16.9%, 39.5% and 44.4%, respectively, of patients with active pulmonary tuberculosis. Markedly elevated serum CA125 levels were found in some cases. On chest X-ray films, the factors associated with elevation of serum tumor marker levels were examined. Serum CEA and SLX levels were correlated with the extent of disease. Pleural effusion had no influence on serum tumor marker levels. Serum SLX levels were higher in patients without a tuberculous cavity than in those with a tuberculous cavity. After therapy with antituberculous drugs, the mean values of serum SLX and CA125 levels significantly decreased. The decrease in mean value of serum CEA levels was not significant, but in 4 of 8 cases, elevated serum CEA levels were normalized after therapy. On the other hand, two cases with increased serum CEA or SLX level died of respiratory failure. These results suggest that to follow up patients with elevated serum tumor markers is useful for the evaluation of disease activity of pulmonary tuberculosis. Further elevation of serum tumor marker levels after antituberculous therapy may indicate the presence of cancer or deterioration of the disease.
对123例活动性肺结核患者的血清肿瘤标志物(癌胚抗原、可溶性白细胞介素-2受体、癌抗原125)进行了评估。结果如下:活动性肺结核患者中,血清癌胚抗原、可溶性白细胞介素-2受体和癌抗原125水平升高的患者分别占16.9%、39.5%和44.4%。部分病例血清癌抗原125水平显著升高。在胸部X线片上,检查了与血清肿瘤标志物水平升高相关的因素。血清癌胚抗原和可溶性白细胞介素-2受体水平与疾病范围相关。胸腔积液对血清肿瘤标志物水平无影响。无结核空洞的患者血清可溶性白细胞介素-2受体水平高于有结核空洞的患者。抗结核药物治疗后,血清可溶性白细胞介素-2受体和癌抗原125水平的平均值显著下降。血清癌胚抗原水平平均值下降不显著,但8例中有4例治疗后血清癌胚抗原升高水平恢复正常。另一方面,2例血清癌胚抗原或可溶性白细胞介素-2受体水平升高的患者死于呼吸衰竭。这些结果表明,对血清肿瘤标志物升高的患者进行随访有助于评估肺结核的疾病活动度。抗结核治疗后血清肿瘤标志物水平进一步升高可能提示癌症存在或疾病恶化。