摘要： 目的 探讨肿瘤标志物在结缔组织病（CTD）相关间质性肺疾病（ILD）中的预测价值。方法 采用电化学发光法检测20例健康对照组、495例CTD-ILD和378例CTD不合并间质性肺疾病（CTD-nILD）患者的血清肿瘤标志物水平，并收集临床资料。结果 健康对照组、CTD-nILD组和CTD-ILD组3组间的血清甲胎蛋白（AFP）、癌胚抗原（CEA）、神经元特异性烯醇化酶（NSE）、糖类抗原（CA）153、CA125、CA199、细胞角蛋白19片段（CYFRA21-1）水平有统计学差异。不同CTD的ILD患者血清CEA、NSE、CA153、CA125、CYFRA21-1和鳞状细胞癌相关抗原（SCC）水平存在统计学差异；不同的HRCT分型之间CEA、NSE、CA153、CA125和CYFRA21-1存在统计学差异；血清CA153在原发性干燥综合征相关间质性肺疾病（pSS-ILD）、肌炎相关间质性肺疾病（DM-ILD）、系统性硬化症相关间质性肺疾病（SSc-ILD）、类风湿性关节炎相关间质性肺疾病（RA-ILD）患者中预测价值最大；血清CEA在混合性CTD-ILD（MCTD-ILD）患者中预测价值最大；多种肿瘤标志物联合预测CTD-ILD价值更高。结论 CTD-ILD患者血清肿瘤标志物水平升高，不同CTD的ILD患者肿瘤标志物表达存在差异，多种肿瘤标志物联合检测有助于CTD-ILD的诊断与预测。

血清肿瘤标志物检测在结缔组织病相关间质性肺疾病患者中的临床意义

颜菲¹, 范观止², 刘一平¹, 胡明¹, 郭迪森¹, 张榕¹

1. 中国医科大学附属第一医院风湿免疫科, 沈阳 110001;
2. 中国医科大学附属盛京医院病理科, 沈阳 110004

收稿日期:2022-10-17出版日期:2023-02-28发布日期:2023-02-04
通讯作者:张榕E-mail:zhangrongcmu@163.com
作者简介:颜菲(1995-),女,医师,硕士.
基金资助:辽宁省自然科学基金（20180550997）；辽宁省应用基础研究计划（2022JH2/101300046）


关键词: 结缔组织病, 间质性肺疾病, 血清肿瘤标志物
Abstract: Objective The study aimed to evaluate the significance of tumor markers in the prediction of connective tissue disease-associated interstitial lung disease (CTD-ILD). Methods Serum tumor markers were measured by the electrochemiluminescence method in 20 healthy controls, 495 patients with CTD-ILD, and 378 patients with CTD-nILD, and clinical data were collected. Results There were significant differences in serum alpha-fetoprotein, carcinoembryonic antigen (CEA), neuron-specific enolase (NSE), carbohydrate antigen (CA) 153, CA125, CA199, and cytokeratin 19 fragment (CYFRA21-1) among the healthy control, CTD-nILD, and CTD-ILD groups. In addition, there were statistical differences in the levels of serum CEA, NSE, CA153, CA125, CYFRA21-1, and squamous cell carcinoma-associated antigen (SCC) in ILD patients with different CTDs; and there were statistical differences in CEA, NSE, CA153, CA125, and CYFRA21-1 among different HRCT types. Serum CA153 had the highest predictive value in patients with pSS-ILD, DM-ILD, SSc-ILD, and RA-ILD; and serum CEA had the highest predictive value in MCTD-ILD patients. The combination of other tumor markers demonstrated a higher value in predicting CTD-ILD. Conclusion There was an increased level of serum tumor markers in patients with CTD-ILD, and the expression of tumor markers varied among patients with different CTDs. The combined detection of multiple tumor markers is helpful in the diagnosis and prediction of CTD-ILD.
Key words: connective tissue diseases, interstitial lung disease, serum tumor marker
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