肿瘤标志物与特发性肺纤维化关系初步探讨  

The Relationship Between Tumor Biomarkers and Idiopathic Pulmonary Fibrosis

作　　者：柴晶晶[1] 柳涛[1] 蔡柏蔷[1] 郭子建[1] 

机构地区：[1]中国医学科学院北京协和医学院北京协和医院呼吸内科,北京100730

出　　处：《中国呼吸与危重监护杂志》2011年第1期38-41,共4页Chinese Journal of Respiratory and Critical Care Medicine

摘　　要：目的探讨多种肿瘤标志物与特发性肺纤维化(IPF)之间的关系,并对预后进行相关分析,研究其在IPF中的作用和价值。方法回顾性分析北京协和医院2000年1月至2010年6月IPF患者的临床资料,对其中未发现肿瘤证据且进行外周血多种肿瘤标志物[甲种胎儿球蛋白(AFP)、癌抗原50(CA50)、癌抗原24-2(CA24-2)、癌胚抗原(CEA)、糖链抗原19-9(CA19-9)、癌抗原125(CA125)、癌抗原15-3(CA15-3)、组织多肽抗原(TPA)、神经特异烯醇化酶(NSE)、细胞角蛋白19片段(Cyfra211)]检测的43例IPF患者进行统计分析及随访。结果 43例无肿瘤证据的IPF患者外周血CEA、CA19-9、CA125、CA15-3、TPA水平均明显高于正常值,AFP、CA50、CA24-2、NSE、Cyfra211无明显升高。多种肿瘤标志物与6分钟步行距离、用力肺活量占预计值百分比(FVC%pred)、肺总量占预计值百分比(TLC%pred)、一氧化碳弥散率(DLCO/VA)、PaO2、氧合指数(PaO2/F iO2)、肺泡动脉血氧分压差(P(A-a)O2)、支气管肺泡灌洗液(BALF)细胞分类及CD4/CD8各参数间无明显相关性。根据血清CEA、CA19-9、TPA水平分组,CA19-9升高组生存时间明显低于正常组(P<0.05);CEA、TPA升高组生存时间与正常组比较无显著差异(P>0.05)。糖皮质激素治疗组和非糖皮质激素治疗组生存时间无显著差异(P>0.05)。结论 IPF患者多种肿瘤标志物升高,尤其CA19-9呈明显升高,升高程度与疾病严重程度无明显相关性,但与预后明显相关,可提示疾病进展,是预后不良的标志。Objective To evaluate the relationship between multiple tumor biomarkers and idiopathic pulmonary fibrosis（IPF）,and analyze the prognostic value of these biomarkers in IPF.Methods Clinical data of 43 confirmed IPF patients with no evidence of malignant disaeses,admitted in Peking Union Medical College Hospital between January 2000 and June 2010,were retrospectively analyzed.All IPF patients had detected serum alpha fetoprotein（AFP）,cancer antigen 50（CA50）,cancer antigen 24-2（CA24-2）,carcinoembryonic antigen（CEA）,carbohydrate antigen 19-9（CA19-9）,cancer antigen 125（CA125）,cancer antigen 15-3（CA15-3）,tissue polypeptide antigen（TPA）,neuron specific enolase（NSE）,and cytokeratin-19-fragment（Cyfra211）.Results The serum levels of CEA,CA19-9,CA125,CA15-3,and TPA were obviously higher than normal range,while the serum levels of AFP,CA50,CA24-2,NSE,and Cyfra211 were within normal range.Neither tumor biomarkers had correlation with 6-minute walk distance,FVC%pred,TLC%pred,DLCO/VA,PaO2,PaO2/FiO2,P（A-a）O2,BALF cell differentiation counting,or CD4/CD8.The patients with increased CA19-9 level had shorter survival time than those with normal CA19-9 level（P0.05）.There was no significant difference in survival time between the patients with increased CEA/TPA levels and those with normal CEA/TPA levels（P0.05）,neither between the patients with glucocorticoid treatment and those with non-glucocorticoid treatment（P0.05）.Conclusions Multiple tumor biomarkers,especially CA19-9,increase in IPF patients.The degrees of those increases are not associated with the severity of disease,but closely relate to prognosis,and may also indicate the progression. The increases of multiple tumor biomarkers may be a sign of poor prognosis of IPF with no evidence of malignant disaeses.

关 键 词：特发性肺纤维化 肿瘤标志物 预后 

分 类 号：R563.9[医药卫生—呼吸系统]