苏清芳.类风湿关节炎患者血清肿瘤标志物检测的临床意义[J].实用中西医结合临床,2015,15(8): |
类风湿关节炎患者血清肿瘤标志物检测的临床意义 |
The clinical significance of the tumor marker detectionin in patients with rheumatoid arthritis |
投稿时间:2015-07-09 修订日期:2015-07-09 |
DOI: |
中文关键词: 关节炎,类风湿,肿瘤标志物 |
英文关键词: Arthritis,Rheumatoid,tumor markers |
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中文摘要: |
【】目的:探讨类风湿关节炎患者血清肿瘤标志物的含量变化及其阳性率, 探讨肿瘤标志物与RA疾病活动度的关系及肿瘤发生情况。方法:选择2004年-2013年180例确诊类风湿关节炎同时行肿瘤标志物检测的住院患者,以年龄性别相匹配的健康体检者130例作为对照,并收集类风湿关节炎的疾病活动分数(DAS28)、血沉(ESR)、C-反应蛋白(CRP)、类风湿因子(RF)等资料。肿瘤标志物升高患者均进行胸片、胸部高分辨CT、盆腹部超声或CT、胃镜、肠镜等相关检查明确肿瘤情况,并随访2年以上观察后续肿瘤发生情况。结果:与健康对照组相比,类风湿关节炎患者除CA153外,血清CEA、 CA125、 CA199水平及阳性率与健康对照组比较均升高,差异有统计学意义(P<0.05),分别为 CEA (4.1±2.4 versus 1.9±0.9 ng/ml、 CA125 (24.1±2.8 versus 15.7±2.1U/ml) and CA19-9 (14.9±3.6 versus 10.3±2.1U/ml)。二者阳性率比较:CEA3.3% versus 1.8%,CA125 11.7% versus 5.4% ,CA153 1.7% versus 1.8%, CA199 8.3% versus 3.6%。但类风湿组肿瘤标志物升高与疾病活动分数、血沉或C-反应蛋白无相关性,肿瘤标志物升高的患者未发现肿瘤共存依据。结论:类风湿关节炎血清CEA、CA125、CA199升高,但并不提示相关肿瘤共存,以后患肿瘤风险是否增加仍需继续随访。 |
英文摘要: |
【】 0bjective:To investigate the concentration and the positive rate of tumor marker(TM) in the patients with rheumatoid arthritis(RA). Methods :We assessed levels of TM in the sera of 60 RA patients and 56 age- and sex-matched healthy subjects.TM including CEA, CA125,CA153, and CA199 .Disease markers including erythrocyte sedimentation rate (ESR)、28 ioint indices score(DAS28) and C-reactive protein(CRP)were also collected .Patients with abnormal TM were submitted to further investigation, including chest X-ray, chest CT,colonoscopy, abdominal ultrasonography, upper gastrointestinal endoscopy ,depending on the type of tumor marker that was elevated. Resultands: The mean absolute serum levels of CEA (4.1±2.4 versus 1.9±0.9 ng/ml、 CA125 (24.1±2.8 versus 15.7±2.1U/ml) and CA19-9 (14.9±3.6 versus 10.3±2.1U/ml) were significantly higher in RA compared to controls (P < 0.05).There were significantly more RA patients showing abnormally high levels of CA125 (10.8% versus 7.1%), CA19-9 (8.1% versus 0%), and CA15-3 (17.6% versus 14.3%) in comparison to controls (P < 0.05). There were no significant difference of CA153 between the two groups(1.7% versus 1.8%), There were no correlation with elevated tumor markers and disease activity score(DAS28), erythrocyte sedimentation rate (ESR) or C- reactive protein (CRP) in patients with rheumatoid arthritis , and no tumors were found in patients with high TM.Conclusions :Patients with RA had higher levels of CEA 、CA125 and CA 19-9 more than controls (P < 0.05) . No correlation was found betweenStumor markersSand RA disease activity assessed by the Disease Activity Score 28. No neoplasms were found in Patients with RA who had high levels of serum CEA, CA125, CA199 , whether there will be more cancer risk need to continue to follow up. |
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