间质性肺疾病与血清肿瘤标记物的关系

Study on the Difference of Tumor Markers in Interstitial Pulmonary Disease, Lung Cancer and Bronchial Asthma

摘要: 目的：揭示血清肿瘤标记物(CEA、NSE、CYPRA21-1、CA199、SCC、CA125)与间质性肺疾病之间的关系，肿瘤标记物阳性率及水平在间质性肺疾病(Interstitial pulmonary disease, ILD)、支气管哮喘、肺癌中有无差异；方法：收集2015年5月至2020年12月于云南省第一人民医院确诊为ILD的患者100例，收集同期诊断为支气管哮喘的患者51例，为对照A组，同期病理证实为肺癌的患者53例，为对照B组，测定三组患者血清中CEA、NSE、CYPRA21-1、CA199、SCC、CA125的水平，比较三组中不同血清肿瘤标记物的差异。结果：ILD组血清CEA、NSE、CYPRA21-1、CA125的阳性率与肺癌组无明显差异(P值均 > 0.05)，ILD组、肺癌组中CEA、NSE、CYPRA21-1、CA125的阳性率均高于支气管哮喘组(P值均 < 0.01)，CA199的阳性率在ILD组与肺癌组间的差异无统计学意义(P = 0.364)，SCC的阳性率在三组间的差异无统计学意义(P = 0.265)；CEA、CYPRA21-1、CA199、CA125的水平在ILD组与肺癌组间的差异均无统计学意义(P值均 > 0.05)，ILD组、肺癌组中CEA、CYPRA21-1、CA199、CA125的水平均高于支气管哮喘组(P值 < 0.05)，SCC水平的差异在三者间无统计学意义(P = 0.829)，NSE的水平在三组中由高到低为：肺癌组 > ILD组 > 支气管哮喘组(P值均 < 0.05)；结论：① CEA、NSE、CYPRA21-1、CA199、SCC、CA125在ILD患者中有不同程度的升高，但其升高的临床意义目前尚无统一结论；② 支气管哮喘患者中CEA、NSE、CYPRA21-1、CA199、CA125阳性率及水平明显低于ILD及肺癌组；③ 多种肿瘤标记物的水平及阳性率在ILD与肺部恶性肿瘤间的差异无统计学意义，肿瘤标记物对两者的鉴别作用有限。

Abstract: Objective: To reveal the relationship between serum tumor markers (CEA, NSE, CYPRA21-1, CA199, SCC, CA125) and interstitial lung disease, and whether there is any difference in the levels of interstitial lung disease, bronchial asthma, and lung cancer. Methods: A total of 100 patients diagnosed with ILD in the First People’s Hospital of Yunnan Province from May 2015 to December 2020 were collected as the case group, and 51 patients diagnosed with bronchial asthma during the same period were collected as the control group A, the same pathology confirmed for 53 patients with lung cancer, for control group B, the levels of CEA, NSE, CYPRA21-1, CA199, SCC and CA125 in the three groups were measured, and the differences of serum tumor markers in each group were compared. Results: The positive rates of serum CEA, NSE, CYPRA21-1 and CA125 in ILD group and lung cancer group had no significant difference (P > 0.05). The positive rates of CEA, NSE, CYPRA21-1 and CA125 in ILD group and lung cancer group were higher than those in asthma group (P < 0.01). There was no statistically significant difference in the positive rate of CA199 between ILD group and lung cancer group (P = 0.364), and there was no statistically significant difference in the positive rate of SCC among the three groups (P = 0.265). The levels of CEA, CYPRA21-1, CA199 and CA125 were not significantly different between ILD group and lung cancer group (P > 0.05). The levels of CEA, CYPRA21-1, CA199 and CA125 in ILD group and lung cancer group were higher than those in asthma group (P < 0.05), but there was no statistical significance in SCC level among the three groups (P = 0.829). NSE level in the three groups from high to low is: lung cancer group > ILD group > Bronchial asthma group (all P < 0.05). Conclusion: ① CEA, NSE, CYPRA21-1, CA199, SCC and CA125 are increased in ILD patients to varying degrees, but there is no unified conclusion on the clinical significance of these increases. ② The positive rates and levels of CEA, NSE, CYPRA21-1, CA199 and CA125 in bronchial asthma patients were significantly lower than those in ILD and lung cancer group. ③ There was no statistical significance in the level and positive rate of various tumor markers between ILD and lung malignant tumors, and the role of tumor markers in the differentiation between ILD and lung malignant tumors was limited.