629例尘肺病患者血清肿瘤标志物水平分析  

Analysis of serum tumor marker levels in 629 patients with pneumoconiosis

作　　者：李晔[1] 徐光[1] 毛善慈 鲁华业 韩磊[1] Li Ye;Xu Guang;Mao Shanci;Lu Huaye;Han Lei(Jiangsu Provincial Center for Disease Control and Prevention,Nanjing 210028,China)

机构地区：[1]江苏省疾病预防控制中心职业病防治所,南京210028

出　　处：《中华劳动卫生职业病杂志》2025年第1期54-57,共4页Chinese Journal of Industrial Hygiene and Occupational Diseases

基　　金：江苏省医学重点学科(ZDXK202249)。

摘　　要：目的分析尘肺病患者血清肿瘤标志物水平与尘肺病病情之间的关系。方法于2024年4月,对江苏省尘肺病康复点进行整群抽样,将所选康复点2023年接受尘肺病随访体检的629例患者进行回顾性分析,另选281例在江苏省疾病预防控制中心职业病防治所进行职业健康体检的健康志愿者为空白对照组,某煤矿企业384例接尘劳动者为接尘对照组。检测各组研究对象血清肿瘤标志物癌胚抗原(carcinoembryonic antigen,CEA)、糖类抗原199(carbohydrate antigen199,CA199)、神经元烯醇化酶(neuron-specific enolase,NSE)的水平,测定用力肺活量(forced vital capacity,FVC)、第1秒用力呼气容积(forced expiratory volume in one second,FEV_(1))和血中乳酸脱氢酶(lactate acid dehydrogenase,LDH)含量。用有序独立样本的非参数检验Jonckheere-Terpstra检验进行多组间肿瘤标志物表达水平比较;用Spearman秩相关分析血清肿瘤标志物与尘肺病分期及肺功能参数的相关性。结果629例尘肺病患者中壹期454例,贰期150例,叁期25例。不同期别尘肺病患者组、空白对照组、接尘对照组间血清CEA、CA199、NSE表达水平差异有统计学意义(P<0.001),血清CEA、CA199、NSE水平和尘肺期别成正相关(P<0.05)。尘肺病患者血清CA199表达水平与FEV_(1)%呈负相关(r=-0.082,P<0.05),与LDH含量呈正相关(r=0.108,P<0.05)。尘肺病患者血清NSE表达水平与FVC%呈负相关(r=-0.079,P<0.05),与LDH含量呈正相关(r=0.435,P<0.05)。结论尘肺患者血清CA199、NSE水平与患者疾病分期和严重程度呈正相关,可能在判断尘肺病人治疗效果、监测病情发展过程中有实际意义。Objective To investigate the relationship between serum tumor markers and the severity of silicosis.MethodsIn April 2024,A cluster sampling was conducted on the pulmonary rehabilitation centers in Jiangsu Province.A retrospective analysis was carried out on 629 patients who received follow-up physical examinations for pneumoconiosis from April to November 2023 at the selected rehabilitation centers.281 healthy volunteers who underwent occupational health examinations at our institution were selected as the blank control group,and 384 dust exposed workers from a coal mining enterprise were selected as the dust exposed control group.Detect the levels of peripheral bloodtumor markers carcinoembryonic antigen CEA,carbohydrate antigen CA199,and neuron-specific enolase NSE in specimens.Measure the patient's forced vital capacity(FVC),forced expiratory volume in one second(FEV_(1)),and lactate acid dehydrogenase(LDH)levels in the blood.The Jonckheere-Terpstra test,a non-parametric test for ordered independent samples,was used to compare the expression levels of tumor markers among multiple groups.Spearman's rank correlation analysis was adopted to explore the correlations between serum tumor markers and the staging of pneumoconiosis as well as lung function parameters.ResultsAmong the 629 patients with pneumoconiosis,454 were in stageⅠ,150 were in stageⅡ,25 were in stageⅢ.There were significant differences in serum CEA,CA199 and NSE levels among patients with different periods of pneumoconiosis,blank control group and dust-exposed control group(P<0.001).Serum CEA,CA199 and NSE levels were positively correlated with pneumoconiosis stage(P<0.05).There is a negative correlation between serum CA199 levels and FEV_(1)%in patients with pneumoconiosis(r=-0.082,P<0.05).The serum CA199 level was positively correlated with LDH in patients with pneumoconiosis(r=0.108,P<0.05).The serum NSE level of pneumoconiosis patients was negatively correlated with FVC%(r=-0.079,P<0.05).There is a positive correlation between serum NSE le

关 键 词：尘肺 血清:肿瘤标志物 癌胚抗原 糖类抗原199 神经元烯醇化酶 

分 类 号：R135.2[医药卫生—劳动卫生]