类风湿关节炎患者CA125升高相关因素  

Influencing Factors for Elevated CA125 in Patients with Rhumatoid Arthritis

作　　者：陈素云[1] 吴春龙[1] 李俊[1] 沈益敏[1] 颜海希[1] 沈波[1] 陈世勇[1] 

机构地区：[1]浙江省台州医院检验科,台州317000

出　　处：《中华临床免疫和变态反应杂志》2015年第1期26-30,共5页Chinese Journal of Allergy & Clinical Immunology

摘　　要：目的检测类风湿关节炎（rhumatoid arthritis,RA）患者血清肿瘤标志物水平,分析其变化及其相关因素。方法采用化学发光微粒子免疫分析方法检测RA患者（RA组）和健康体检者（对照组）肿瘤标志物（CEA、CA199、CA125、CA153）水平,收集RA患者相关资料,分析RA患者肿瘤标志物水平变化及与实验室指标和临床表现的相关性。结果 RA组患者98例,对照组受试者100例。RA组CEA和CA125浓度及CA125阳性率明显高于对照组,差异有统计学意义[1.85（1.11,2.52）ngml vs.1.50（1.00,2.28）ngml,18.10（9.87,33.88）Uml vs.10.20（7.10,14.78）Uml,23.5%vs.2.0%,均P〈0.05]。单因素Logistic回归分析显示,RA患者血清CA125水平升高与C反应蛋白[比值比（odds ratio,OR）=1.041,95%可信区间（confidence interval,CI）为1.002-1.082,P=0.041]、Ig A（OR=1.003,95%CI为1.001-1.006,P=0.020）、Ig M（OR=1.006,95%CI为1.002-1.010,P=0.004）水平及肺部疾病受累（OR=3.740,95%CI为1.304-10.729,P=0.014）有关,而与其他实验室指标及高血压、吸烟、贫血、血小板计数升高、胸腔积液、病程、疾病活动度DAS28无关。多因素Logistic回归分析示,肺部受累（OR=3.909,95%CI为1.201-12.722,P=0.024）和Ig M水平（OR=1.005,95%CI为1.001-1.010,P=0.020）与CA125水平升高显著相关。结论 RA患者某些肿瘤标志物水平（CEA、CA125）会升高,其CA125水平的升高与疾病活动度等无关,可能与肺部器官的受累相关。Objective To investigate the variation of serum tumor markers in rhumatoid arthritis （RA）and its related factors.Methods By using chemiluminescent microparticle immunoassay,the serum levels of tumor markers carcinoembryonic antigen （CEA）,cancer antigen （CA）19-9,CA125 and CA15-3 in patients with RA and controls were examined,and the variation of serum tumor markers and the correlation between elevated serum marker with clinical and laboratorial information were analyzed.Results There were 98 patients in the RA group and 100 subjects in the control group.The levels of CEA and CA125 level in the RA patients were significantly higher than controls.Significantly more patients were “positive” for CA125 than controls [1.85（1.11,2.52）ng/ml vs.1.50（1.00,2.28）ng/ml,18.10（9.87,33.88） U/ml vs.10.20（7.10,14.78）U/ml,23.5% vs.2.0%,all P 〈0.05].Single factor analysis showed that the levels of C-reactive protein [odds ratio（OR）=1.041,95% confidence interval（CI）：1.002-1.082,P =0.041],IgA （OR =1.003,95%CI：1.001-1.006,P =0.020）,IgM （OR =1.006,95%CI：1.002-1.010,P =0.004）,and lung involvement （OR =3.740,95% CI：1.304-10.729,P =0.014）were associated with elevated serum CA125 level in RA patients.There were no significant differences in other clinical and laboratory variables including hypertension, smoke, anemia, thrombocytosis,pleural effusion,disease duration and disease active score 28.After multivariate logistic regressive analysis,lung involvement（OR =3.909,95%CI：1.201-12.722,P =0.024）and IgM level （OR =1.005,95% CI：1.001-1.010,P =0.020）were the only two variables that were significantly associated with elevation of serum CA125 level.Conclusion The concentration of some tumor markers CEA and CA125 may be elevated in the serum of RA patients,the positive rate of CA 125 in sera is high in RA patients,which may be related to lung involemen,but not to the activity of the RA.

关 键 词：类风湿关节炎 肿瘤标志物 相关性 

分 类 号：R593.22[医药卫生—内科学]