系统性红斑狼疮患者血清肿瘤标志物水平变化及其意义  

Changes and significance of serum tumor markers in patients with systemic lupus erythematosus

作　　者：张敏敏 周玮[2] 谭薇[2] 庞雨冰 王慧 沈维干[3] 张育[1] ZHANG Minmin;ZHOU Wei;TAN Wei;PANG Yubing;WANG Hui;SHEN Weigan;ZHANG Yu(The Affiliated Subei People's Hospital of Yangzhou University,Yangzhou 225001,China)

机构地区：[1]扬州大学附属苏北人民医院,江苏扬州225001 [2]扬州大学附属医院 [3]扬州大学医学院

出　　处：《山东医药》2019年第27期25-28,共4页Shandong Medical Journal

基　　金：国家自然科学基金资助项目(81601420)

摘　　要：目的观察系统性红斑狼疮(SLE)患者血清肿瘤标志物糖类抗原125(CA125)、糖类抗原153(CA153)、糖类抗原199(CA199)、癌胚抗原(CEA)及甲胎蛋白(AFP)水平异常情况,并探讨其临床意义.方法232例SLE患者,采集空腹静脉血,检测血清CA125、CA153、CA199、CEA及AFP,分析血清肿瘤标志物水平异常(检测结果超过其对应的正常参考值范围)情况.收集232例患者的临床资料,Person相关性分析法分析SLE患者血清肿瘤标志物水平异常与SLE疾病活动度的相关性,采用Logistic回归分析法分析SLE患者血清肿瘤标志物水平异常的影响因素.结果232例SLE患者中75例血清肿瘤标志物(A125、CA153、CA199、CEA及AFP)水平异常(32.3%,75/232);其中,血清CA125、CA153、CA199、CEA、AFP水平异常者分别为44例(58.6%,44/75)、15例(20.0%,15/75)、25例(33.3%,25/75)、14例(18.7%,14/75)及6例(8.0%,6/75).与血清肿瘤标志物水平正常者比较,血清肿瘤标志物水平异常的SLE患者并发感染、肺间质病变及肝功能异常比例显著增高,抗SSA抗体及抗Sm抗体阳性率低(P<0.05);合并感染、肺间质病变及肝功能异常(OR分别为1.881,1.871,2.186;95%CI分别为1.016~3.48,1.021~3.428,1.024~4.668;P均<0.05)是SLE患者肿瘤标志物异常的独立危险因素;疾病活动度SLE-DAI评分>9分的SLE患者血清CA125、CA199水平异常发生率显著高于SLEDAI评分≤9分SLE患者(P均<0.05).SLE患者血清肿瘤标志物异常的水平与其疾病活动度无关.结论SLE患者中存在血清CA125、CA153、CA199、CEA及AFP水平异常者.血清CA125、CA153、CA199、CEA及AFP水平异常的SLE患者常合并感染、肺间质病变及肝功能异常.SLE患者CA125、CA199异常的发生率与疾病活动度有关.Objective To observe the changes of the carbohydrate antigen 125(CA125),carbohydrate antigen 153(CA153),carbohydrate antigen 199(CA199),carcinoembryonic antigen(CEA),and alpha-fetoprotein(AFP)in patients with systemic lupus erythematosus(SLE)and their meanings.Methods The fasting venous serum CA125,CA153,CA199,CEA and AFP were tested in 232 patients,and we analyzed the abnormal serum tumor markers(the test result exceeds the normal reference range).The clinical data of 232 SLE patients were collected.Person correlation analysis was used to analyze the correlation between abnormal serum tumor markers and disease activity in SLE patients.Logistic regression analysis was used to analyze the influencing factors of abnormal serum tumor markers for SLE patients.Results Seventy-five patients with serum tumor markers(A125,CA153,CA199,CEA,and AFP)were abnormal in 232 SLE patients(32.3%,75/232).Among them,the serum CA125,CA153,CA199,CEA,AFP levels were found abnormal in 44 cases(58.6%,44/75),15 cases(20.0%,15/75),25 cases(33.3%,25/75),14 cases(18.7%,14/75),and 6 cases(8.0%,6/75),respectively.The proportion of patients with co-infection,interstitial lung disease,and liver dysfunction was higher in the abnormal tumor markers group than in the normal tumor markers group and the positive rate of anti-SSA antibody and anti-Sm antibody decreased(both P<0.05).Co-infection interstitial lung disease and abnormal liver function(OR=1.881,1.871,and 2.186;95%Cl=1.016-3.48,1.021-3.428,and 1.0244 668,respectively;all P<0.05)were independent risk factors for tumor marker abnormalities in SLE patients.The abnormal incidence of serum CA125 and CA199 in SLE patients with SLEAI score>9 points was significantly higher than that in SLE patients with SLEDAI score W9(P<0.05).Abnormal levels of serum tumor markers in SLE patients were not associated with disease activity.Conclusions Abnormal serum levels of CA125,CA153,CA199,CEA and AFP are found in SLE patients.SLE patients with abnormal serum levels of CA125,CA153,CA199,CEA,and AFP often have in

关 键 词：系统性红斑狼疮 肿瘤标志物 糖类抗原125 糖类抗原153 糖类抗原199 癌胚抗原 甲胎蛋白 

分 类 号：R73[医药卫生—肿瘤]