Relationship Between Tumor Markers And Different Types Of Interstitial Lung Disease

Objective:Retrospectively analyze of the serum tumor markers carcinoembryonic antigen（CEA）,cancer antigen 125（CA125）,cancer antigen 199（CA199）,neuron specific enolase（NSE）,cytokeratin 19 fragment（CYFRA21-1）,cancer antigen 153（CA153）,artery blood oxygen partial pressure（PaO2）,alveolar arterial oxygen partial pressure difference（P（A-a）O2）in patients with different types of interstitial lung disease（ILD）.Explore the value of differential diagnosis and predictive effect of disease severity in ILD by observing of serum tumor marker levels in Idiopathic pulmonary fibrosis（IPF）,idiopathic non-specific interstitial pneumonia（i-NSIP）,connective tissue disease-related interstitial lung disease（CTD-ILD）and correlation between tumor markers and arterial blood gas analysis indicators.Methods:Retrospectively analyze of patients with interstitial lung disease who were admitted to the Department of Respiratory Medicine,Tianjin Haihe Hospital,from January 2013 to January 2018.Grouped according to clinical data,imaging and pathological biopsy results.Patients with the following conditions,1.combined with neoplastic disease,chronic cholecystitis and other diseases that may lead to elevated tumor markers 2.data records are incomplete 3.patients with granulomatous interstitial lung disease or rare interstitial lung disease.172 patients with clear diagnosis were divided into three groups.The study included 31 patients with IPF,including15（48.4%）males and 16（51.6%）females.There were 84 patients with i-NSIP,including 45（53.6%）males and 39（46.4%）females.There were 57 patients with CTD-ILD,including 25 males（43.9%）and 32 females（56.1%）,including 10cases of CTD-ILD（untyped）,24 cases of CTD-ILD（rheumatoid arthritis）14 cases of CTD-ILD（myositis）and 9 cases of CTD-ILD（sjogren’s syndrome）.The results of the arterial blood gas analysis and tumor markers were reviewed to analyze whether there were differences in tumor marker levels between IPF,i-NSIP and CTD-ILD,and whether there were differences in tumor marker levels in CTD-ILD subgroup,and to analyze the correlation between tumor markers and arterial blood gas analysis.Results:1.Comparison results between the three groups,group A VS group B:all tumor markers were not significantly different,group A VS group C:the level of CA153 in group A was obviously higher than that in group C（P<0.05）,and the other tumor markers were not statistically significant,group B VS group C:the level of CA153 in group B was obviously higher than that in group C（P<0.05）,and the other tumor markers were not statistically significant.2.Comparison results in CTD-ILD group:the levels of CA199 and CA153 were obviously higher in the CTD-ILD（rheumatoid arthritis）group than that in the CTD-ILD（untyped）group（p<0.05）.the level of CA199 was obviously higher in the CTD-ILD（rheumatoid arthritis）group than that in the CTD-ILD（myositis）group（p<0.05）.The remaining tumor markers were not statistically significant in the comparison between the any other two groups.3.Correlation between tumor markers and arterial blood gas analysis indicators.Group A:there was no significant correlation between tumor markers and PaO2,P（A-a）O₂（p>0.05）.Group B:CYFRA21-1 and CA153 were positively correlated with P（A-a）O₂（r=0.299,0.605）,but not related to PaO2.There was no significant correlation between the remaining tumor markers and PaO2,P（A-a）O₂.Group C:CA199,CYFRA21-1,and NSE were negatively correlated with arterial oxygen partial pressure（r=-0.295,-0.315,-0.421,respectively）,and the remaining tumor markers were not significantly associated with PaO2.CEA,CA125,CA199,CYFRA21-1 were positively correlated with P（A-a）O₂（r=0.514,0.419,0.319,0.371,respectively）,and the remaining tumor markers were not significantly correlated with P（A-a）O₂.Conclusion:1.The level of tumor marker CA153 is significantly higher than that of CTD-ILD in IPF and i-NSIP,which has certain reference value for the differential diagnosis of diseases.2.The levels of tumor markers CA199 and CA153 are significantly higher in CTD-ILD（rheumatoid arthritis）group than that in the CTD-ILD（myositis）group.For the CTD-ILD that can not be specifically classified at the initial stage,when the levels of CA199 and CA153 are elevated and there is no evidence of tumor,the diagnosis of rheumatoid arthritis with pulmonary interstitial lesions should be considered.3.Tumor markers can reflect the severity of PaO2 and P（A-a）O₂ in ILD to a certain extent.