肿瘤标志物与特发性肺间质纤维化相关性的临床研究

Clinical research on correlation of tumor markers and idiopathic pulmonary fibrosis

摘要:

目的  探讨肿瘤标志物与特发性肺间质纤维化（IPF）之间的关系及其临床意义，以指导IPF早期临床诊断。方法  回顾性对比分析2012年1月-2015年9月于武警总医院住院的IPF患者40例，肺癌患者50例，健康体检者40例，收集3组患者的血清骨胶素（CYFRA211）、烯醇化酶（NSE）、鳞状上皮细胞抗原（SCC）、癌胚抗原（CEA）、抗原125（CA125）、抗原72-4（CA72-4）等肿瘤标志物。结果  IPF患者CYFRA211、NSE、SCC、CEA及CA125水平均显著高于健康对照组（P <0.05），而CA72-4水平相当（P >0.05）。与肺癌患者比较，IPF患者的血清CA125水平显著升高（P <0.05），NSE水平显著降低（P <0.05），而其他肿瘤标志物在两组间差异无统计学意义（P >0.05）。IPF患者血清SCC、NSE的阳性率与肺癌组差异有统计学意义（P <0.05）。在与肺癌的分型比较中，IPF组血清CA125水平高于鳞癌组（P <0.05），SCC水平/阳性率显著高于腺癌组和小细胞肺癌组（P <0.05），血清NSE水平/阳性率均显著低于3个肺癌亚组（P <0.05）；其他肿瘤标志物与3个肺癌亚组之间差异无统计学意义（P >0.05）。结论  IPF患者血清CYFRA211、NSE、SCC、CEA、CA125明显升高。IPF患者血清CA125、SCC可作为IPF的早期诊断指标，而血清NSE水平可作为区分IPF与早期肺癌的一项预测指标。

Abstract:

Objective To investigate the correlation of tumor markers and idiopathic pulmonary fibrosis and its clinical significance in order to instruct the early clinical diagnosis of IPF. Methods We analyzed and compared 40 cases of patients with IPF, 50 cases of patients with lung cancer, and 40 healthy volunteers (the control group) who were admitted in General Hospital of Chinese People's Armed Police Forces from January, 2012 to September, 2015. we  collected the tumor makers from the serum of all three teams above, such as serum cytokeratin19 fragment (CYFRA211), neuron specific enolase (NSE), squamous cell carcinoma antigen (SCC), carcinoembryonic antigen (CEA), cancer antigen 72-4 (CA72-4) and cancer antigen 125 (CA125), et al. Results The serum level of CYFRA211 NSE SCC CEA CA125 in patients with IPF was significantly higher than healthy volunteers (P < 0.05), while the serum level of CA72-4 was comparable (P > 0.05). Compared with patients with lung cancer, the serum level of CA125 in patients with IPF was obviously higher than those with lung cancer (P < 0.05), the serum level of NSE was lower (P < 0.05), but serum level of other tumor markers in both groups had no statistically significant difference (P > 0.05). The positive rate of serum SCC and NSE in patients with IPF and lung cancer group had statistically significant difference (P < 0.05). The analysis of classification and comparison in lung cancer showed that the serum CA125 level in patients with IPF was higher than squamous cell carcinoma (P < 0.05), the serum SCC level/positive rate was significantly higher than that of adenocarcinoma and small cell lung(P < 0.05), the serum NSE level/positive rate was significantly lower than that of sub-groups of patients with lung cancer (P < 0.05), while other tumor markers had no statistical differences in the two groups (P > 0.05). Conclusions The serum level of CYFRA211 NSE SCC CEA and CA125 is significantly higher in IPF patients. The serum CA125 and SCC can be used as two early diagnosis markers of IPF, and serum level of NSE can be used as a predictor to distinguish the IPF and early lung cancer.