Study On The Correlation Between Serum Tumor Markers And The Severity Of Idiopathic Pulmonary Interstitial Fibrosis

Objective:To retrospectively study the expression level of serum tumor markers in idiopathic Pulmonary fibrosis(IPF),analyze the correlation between serum tumor markers and the severity of IPF,and explore the diagnostic value of serum tumor markers in IPF.Methods:From January 2020 to December 2022,76 patients with IPF,62 patients with IPF complicated with lung cancer,and 80 health examinees who were hospitalized in the Respiratory Department of Jilin University First Hospital were retrospectively collected.Comparative analysis of general data such as gender,age,and smoking history among the three groups.Meanwhile,the differences of tumor markers among the three groups were compared and analyzed.The extent of abnormal lung CT images at admission was used as a criterion to evaluate the severity of IPF patients.IPF was divided into three groups:mild,moderate,and severe.The differences in the expression of serum tumor markers among the three groups were compared and analyzed.The levels of serum tumor markers in the IPF group during fasting and 3 months after anti fibrosis treatment were compared and analyzed.Results:1.Comparison of general data:There were statistically significant differences in gender,age,and smoking history among the three groups(P<0.05).Older men with a smoking history were more likely to have lung cancer in IPF patients.2.Comparison of tumor markers in three groups:Compared with the control group,the expression levels of Cyfra21-1,CEA,SCCA,and CA199 in the serum of the IPF group were significantly increased,with a statistically significant difference(P<0.05).Compared with the IPF combined lung cancer group and the IPF group,the expression levels of CEA and NSE in the serum were significantly increased,with a statistically significant difference(P<0.05),indicating that the increase in tumor markers in IPF patients is a common phenomenon.3.Sensitivity and specificity analysis of tumor marker assisted diagnosis of IPF:Through the ROC curve analysis of serum tumor markers in IPF assisted diagnosis,CEA and CA199 have AUC values greater than 0.7,and the AUC value of CA199 is 0.751(95%confidence interval:14.896-41.143).When the threshold value is 13.870U/ml,the sensitivity is 51.6%,and the specificity is 69.0%.The AUC value of CEA is 0.810(95%confidence interval:2.297-5.349).When the threshold value is 3.370U/ml,the sensitivity is 35.5%,and the specificity is 88.8%.When Cyfra21-1,CEA,SCCA,and CA199 were jointly tested,the AUC value was 0.873(95%confidence interval:0.481-0.585),the sensitivity was 66.1%,and the specificity was 93.0%.When combined with CEA and CA199,the AUC value was 0.828(95%confidence interval:0.485-0.586),the sensitivity was 72.6%,and the specificity was 87.3%.4.Correlation analysis between tumor markers and severity of IPF:IPF patients were divided into three groups:mild,moderate,and severe,using the extent of abnormal lung CT imaging involvement at admission as a criterion for assessing the severity of IPF patients,Compared with the mild group,the CEA in the moderate group was significantly higher,with a statistically significant difference(P<0.05).Compared with the moderate group,the CEA in the severe group was significantly higher,with a statistically significant difference(P<0.05).Compared with the mild group,CEA in the severe group increased significantly,with a statistically significant difference(P<0.05),indicating that the higher the degree of pulmonary fibrosis,the higher the level of tumor markers.5.Analysis of the correlation between tumor markers and the efficacy of anti fibrosis therapy:Comparing the levels of tumor markers before and after treatment in the IPF group,the CEA level decreased significantly after treatment,with a statistically significant difference(P<0.05),indicating that the condition improved and the level of tumor markers decreased.6.Correlation of tumor markers with arterial partial pressure of oxygen and lung function:The arterial partial pressure of oxygen and lung function related indicators measured in the IPF group without oxygen inhalation were used as indicators to judge the severity of lung damage.CEA and CA199 were negatively correlated with PO2,FVC%pre,DLCO%pre,DLCO/VA%pre,and lung reserve rate,indicating that the more severe the condition,the higher the level of tumor markers.Conclusion:1.Many serum tumor markers in patients with IPF are elevated,mainly Cyfra211,CEA,NSE,and CA199,indicating that they are involved in the occurrence and development of IPF to a certain extent,and have certain clinical significance for assisting in the diagnosis of IPF.2.Among various serum tumor markers,CEA is associated with the severity of IPF and the efficacy of anti fibrosis therapy.Elevated levels of CEA can be used as a serological method to assess the severity of the disease and the efficacy of anti fibrosis therapy.3.The levels of serum CEA and NSE in patients with IPF and IPF with lung cancer have increased to varying degrees,but the increase is significant in patients with IPF with lung cancer.Therefore,the significant increase of CEA and NSE in IPF patients has a certain degree of warning effect for patients with lung cancer.