| Objective:The purpose of this study is to explore the serological level and clinical significance of tumor markers such as cytokeratin 19 fragment(Cyfra21-1),squamous cell carcinoma antigen(SCCA),carcinoembryonic antigen(CEA),carbohydrate antigen 125(CA125),carbohydrate antigen 153(CA153),carbohydrate antigen 199(CA199),neuron specific enolase(NSE)in patients with different types of connective tissue disease associated interstitial lung disease(CTD-ILD).Methods:1.General data,serum tumor markers,blood gas analysis and pulmonary function were collected from patients with connective tissue disease(CTD)who visited the Second Hospital of Jilin University from 2015 to 2022.2.The groups were divided into rheumatoid arthritis(RA)and rheumatoid arthritis with interstitial lung disease(RA-ILD)groups,primary Sjogren’s syndrome(PSS)and primary Sjogren’s syndrome with interstitial lung disease(PSS-ILD)groups,dermatomyositis/polymyositis(DM/PM)and dermatomyositis/polymyositis with interstitial lung disease(DM/PM-ILD)groups,according to the types of connective tissue disease and whether it was combined with interstitial lung disease(ILD).3.The general conditions and serum tumor markers of each group were compared separately.4.To explore the clinical diagnostic or predictive value of tumor markers in different types of connective tissue disease combined with interstitial lung disease,and to analyze whether there is a correlation between tumor markers and disease severity in connective tissue disease combined with interstitial lung disease.Results:1.Comparison of baseline characteristics between the rheumatoid arthritis combined with interstitial lung disease group and the rheumatoid arthritis group: both groups had more female patients,however,the age and proportion of male patients in the RA-ILD group were significantly higher than those in the RA group(P<0.05).The comparison of serum tumor marker results between the two groups revealed that: compared with RA group,the serum levels of Cyfra21-1,CEA,CA153,CA125 and CA199 in RA-ILD group were significantly higher(P<0.05).The results of ROC curve analysis of serum tumor markers in the diagnosis of RA-ILD showed that serum CA199 had the best diagnostic value,followed by CA153.The results of the correlation analysis between serum tumor marker levels and disease severity(pulmonary function and blood gas analysis indicators)in RA-ILD patients were as follows: serum Cyfra21-1,SCCA,CA153,CA125 and CA199 levels were negatively correlated with DLCO%(r values of-0.038,-0.397,-0.438,-0.428,-0.287,P<0.05);serum Cyfra21-1 and CA125 levels were negatively correlated with FVC%(r values of-0.363,-0.295,P<0.05);serum Cyfra21-1 and CA125 levels were negatively correlated with FEV1%(r values of-0.312,-0.276,P<0.05);serum CA125 level was negatively correlated with Pa O2(r value of-0.329,P<0.05);serum CA125 level was negatively correlated with Sa O2(r value of-0.295,P<0.05).2.Comparison of baseline characteristics between patients with Sjogren’s syndrome combined with interstitial lung disease and patients with Sjogren’s syndrome showed that the majority of patients in both groups were female,and no significant differences were found in gender distribution,age and the presence or absence of smoking history(P>0.05).After comparing the levels of serum tumor markers between the two groups,the results showed that the levels of serum Cyfra21-1,CEA and CA153 in PSS-ILD group were significantly higher than those in PSS group,with statistically significant differences(P<0.05).The results of ROC curve analysis of serum tumor markers in the diagnosis of PSS-ILD: serum CA153 had the best diagnostic value for PSS-ILD,followed by Cyfra21-1and CEA.The correlation analysis of serum tumor markers level with pulmonary function indices in patients with PSS-ILD showed that serum CA153 and NSE levels were negatively correlated with DLCO%(r values of-0.631-0.548,P<0.05);serum CA153 level was negatively correlated with FVC%(r value of-0.433,P<0.05);serum NSE level was negatively correlated with FEV1%(r value of-0.378,P<0.05).The results of correlation analysis between serum tumor markers level and blood gas analysis in PSS-ILD patients showed that tumor markers level did not correlate significantly with Pa O2 and Sa O2(P>0.05).3.Comparison of general information between the dermatomyositis/polymyositis combined with interstitial lung disease group and the dermatomyositis/polymyositis group:the proportion of male patients and the proportion of patients with a history of smoking were higher in the DM/PM-ILD group than in the DM/PM-only group,but the differences between the two groups in terms of gender distribution,age and the presence of smoking history were not statistically significant(P>0.05).The serum tumor markers level of patients in the DM/PM-ILD group and the DM/PM group were compared and found that serum Cyfra21-1,CA153 and CA125 levels of patients in DM/PM-ILD group were significantly higher than those in DM/PM group alone,and the differences were statistically significant(P<0.05).The ROC curve analysis of serum tumor markers in the diagnosis of DM/PM-ILD showed that the diagnostic value of serum CA153 was the best,followed by Cyfra21-1.The results of correlation analysis between serum tumor markers level and pulmonary function indexes in DM/PM-ILD patients showed that serum Cyfra21-1 and CA125 levels were negatively correlated with DLCO%(r values of-0.444,-0.503,P<0.05).The results of correlation analysis between serum tumor markers level and blood gas analysis in DM/PM-ILD patients were as follows: serum Cyfra21-1 and CA125 levels were negatively correlated with Pa O2(r values of-0.460,-0.377,P<0.05);serum Cyfra21-1 and CA125 levels were negatively correlated with Sa O2(r values of-0.332,-0.389,P<0.05).Conclusions:1.Serum Cyfra21-1,CEA,CA153,CA125 and CA199 levels were significantly higher in the RA-ILD patients than in the RA group,with serum CA199 and CA153 having the most meaningful predictors for RA-ILD;serum Cyfra21-1 and CA125 levels could reflect the disease severity of RA-ILD patients to some extent.2.Serum Cyfra21-1,CEA and CA153 levels were significantly higher in the PSS-ILD group than in the PSS group,among which serum CA153 was the most meaningful for the prediction of PSS-ILD,followed by serum Cyfra21-1 and CEA;serum CA153 levels could reflect the disease severity of PSS-ILD patients to a certain extent.3.Serum Cyfra21-1,CA153 and CA125 levels were significantly higher in the DM/PM-ILD group than in the DM/PM group alone,among which serum CA153 and Cyfra21-1 were the most meaningful in predicting DM/PM-ILD;serum CA125 and Cyfra21-1 levels could,to some extent,reflect the disease severity in patients with DM/PM-ILD.4.Among the serum tumor markers measured,serum Cyfra21-1,CA153 and CA125 had higher clinical value in predicting disease and assessment of disease severity in patients with CTD-ILD. |
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