目的探讨血清CA19-9水平在肺间质纤维化中的意义。 方法对四川省人民医院老年呼吸科收治的1例肺间质纤维化患者的血清CA19-9水平、PaO 2及胸部CT进行5年的动态随访, 回顾分析24例血清CA19-9水平> 37 U/mL的肺间质纤维化患者(PF组)的血清CA19-9水平和肺功能情况, 并与30例健康体检者(健康对照组)进行比较。 结果随访期间患者血清CA19-9水平逐渐升高, 从53.45 U/mL上升至1 200 U/mL, 伴胸部CT纤维网状格增加, 不吸氧、静息下的PaO 2逐渐下降, 从54 mm Hg下降至32 mm Hg。PF组与健康对照组血清CA19-9水平比较, 差异有统计学意义[73.8(38.1~1 200.0) U/mL比6.9(2.0~19.1) U/mL, P < 0.01];肺弥散功能比较, 差异有统计学意义[55.0(12.7~87.8) mL·min -1·mm Hg -1比90.4(82.0~134.0) mL·min -1·mm Hg -1, P < 0.05]。CA19-9水平与肺弥散功能呈负相关( r=-0.997, P < 0.01)。 结论肺间质纤维化患者的血清CA19-9异常升高, 可能是患者预后不良的指标
References
[1]
5. Obayashi Y, Fujita J, Nishiyama T, et al. Role of carbohydrate antigens sialyl Lewis (a) (CA19-9) in bronchoalveolar lavage in patients with pulmonary fibrosis. Respiration, 2000, 67:146-152.
[2]
6. Jiro F, Yuka O, Ichiro Y, et al. Marked elevation of CA19-9 in a patient with idiopathic pulmonary fibrosis:CA19-9 as a bad prognostic factor. Respirology, 1998, 3:211-214.
[3]
7. Ohwada A, Takahashi H, Nagaoka I, et al. Effect of cigarette smoke on the mRNA and protein expression of carcinoembryonic antigen (CEA), a possible chemoattractant for neutrophils in human bronchioloalveolar tissues. Thorax, 1995, 50:651-657.
[4]
8. Totani Y, Demura Y, Ameshima S, et al. Serum CA19-9 levels reflect bronchioalveolar lavage fluid neutrophil levels in idiopathic pulmonary fibrosis. Respiration, 2001, 68:438.
[5]
9. Gronowitz E, Pitkanen S, Kjellmer I, et al. Association between serum oncofetal antigens CA19-9 and CA125 and clinical status in patients with cystic fibrosis. Acta Paediatr, 2003, 92:1267-1271.
[6]
10. Totani Y, Demura Y, Ameshima S, et al. Silicosis characterized by increasing serum CA 19-9 in parallel with progression of lung fibrosis. Nihon Kokyuki Gakkai Zasshi, 2000, 38:137-142.
[7]
11. Kodama T, Satoh H, Ishikawa H, et al. Serum levels of CA19-9 in patients with nonmalignant respiratory diseases. J Clin Lab Anal, 2007, 21:103-106.
[8]
1. Ho JJ, Bi N, Yan PS, et al. Characterization of new pancreatic cancer-reactive monoclonal antibodies directed against purified mucin. Cancer Res, 1991, 51:372-380.
[9]
2. Shimizu Y, Hamada T, Tanaka Y, et al. Colonization of CA19-9 and KL-6 to epithelial cells in dilated bronchioles in a patient with idiopathic pulmonary fibrosis complicated by diffuse alveolar damage. Respirology, 2002, 7:281-284.
[10]
3. Mukae H, Hirota M, Kohno S, et al. Elevation of tumor associated carbohydrate antigens in patients with diffuse panbronchiolitis. Am Rev Respir Dis, 1993, 148:744-751.
[11]
4. Atkinson BF, Ernst CS, Herlyn M, et al. Gastrointestinal cancer-associated antigen in immunoperoxidase assay. Cancer Res, 1982, 42:4820-4823.
