【摘要】 目的探讨肿瘤标志物在类风湿性关节炎伴间质性肺病(rheumatoid arthritis with interstitial lung disease,RA-ILD)中的表达及其临床意义。方法收集本院呼吸科2008年1月至2011年1月住院的82例类风湿关节炎患者。根据是否伴有间质性肺病,将其分为RA-ILD组(38例)和RA组(44例),检测两组患者血清肿瘤标志物癌胚抗原(carcinoembryonic antigen,CEA)、糖蛋白抗原15-3(carbohydrate antigen 15-3,CA15-3)、糖蛋白抗原19-9(carbohydrateantigen 19-9,CA19-9)水平,抗环瓜氨酸肽(CCP)抗体水平和肺功能包括用力肺活量(FVC)、第1秒用力呼气量(FEV1)、一氧化碳弥散量(DLCO)占预计值百分比,分析两组患者肿瘤标志物表达差异以及RA-ILD组肿瘤标志物与肺功能、抗CCP抗体相关性。结果 RA-ILD组外周血CEA、CA15-3、CA19-9水平均显著高于RA组(P<0.01);RA-ILD组FVC、FEV1和DLCO占预计值百分比均显著低于RA组(P<0.01),但是RA-ILD组抗CCP抗体水平与RA组无显著性差异(P>0.05)。RA-ILD组CEA水平与FVC、FEV1和DLCO呈负相关(r值分别为-0.499、-0.576、-0.512,P<0.0l),但CEA、CA15-3和CA19-9均与抗CCP抗体无相关性(r值分别为-0.192、-0.264、-0.268)。结论肿瘤标志物CEA、CA15-3和CA19-9在RA-ILD中表达升高,CEA可能反应RA-ILD肺功能受损的严重程度,可能与关节损害无密切相关性。更多还原

【Abstract】 Objective To explore the correlation of tumor markers with lung function in rheumatoid arthritis(RA) accompanied with interstitial lung diseases.Methods Eighty-two RA inpatients in our hospital from January 2009 to January 2011 were recruited in this study.Among these RA patients,38 were accompanied with interstitial lung diseases,and the left 44 were not.Tumor markers,such as CEA,CA15-3,CA19-9,and pulmonary function indexes,including forced expiratory volume(FVC),first second forced expiratory volume(FEV1),carbon monoxide diffusion capacity(DLCO),and anti-CCP antibody were detected in all of patients.Correlation between the expression of these markers and pulmonary function indexes,level of anti-CCP antibody was analyzed by Spearman Rank Correlation.Results Serum levels of CEA,CA15-3 and CA19-9 were significantly higher in RA-ILD group than in RA group(P<0.01).The percentage of predicted value for FVC,FEV1 and DLCO was significantly lower in RA-ILD group than in RA group(P<0.01).There was no significant difference between two groups in anti-CCP level(P>0.05).Serum CEA level was inversely correlated with FVC(r=-0.499,P<0.0l),FEV1(r=-0.576,P<0.01) and DLCO(r=-0.512,P<0.01) in RA-ILD patients.There was no correlation between serum level of CEA,CA15-3 and CA19-9 and anti-CCP antibody in RA-ILD patients(r=-0.192,-0.264,-0.268,respectively,P>0.05).Conclusion The expression of tumor markers,including CEA,CA15-3 and CA19-9 is increased in RA-ILD.CEA level may reflect the degree of lung function impairment in RA-ILD,but have no relation with the joint lesion severity.更多还原