不同肺部疾病血清CA19-9水平的比较研究

Comparison of CA19 - 9 Concentration Among Different Pulmonary Diseases

目的通过检测不同肺部疾病患者血清CA19-9水平,探讨CA19-9与肺部疾病的相关性。方法对65例健康体检者和167例住院治疗的肺部疾病病人行血清CA19-9测定,包括慢性阻塞性肺疾病急性加重期(AECOPD)65例,肺癌63例、特发性肺纤维化(IPF)16例,胶原血管病相关性肺纤维化(CDPF)14例,弥漫性泛细支气管炎(DBP)9例,比较不同肺部疾病血清CA19-9水平的差异。结果与健康对照组(中位数=5.75U/ml)相比,肿瘤标志物CA19-9在肺癌患者中明显升高(中位数=29.87U/ml)(P<0.05);在其他肺部非恶性疾病中也明显升高(P<0.05):其中IPF组(中位数=61.61U/ml)、CDPF组(中位数=59.0U/ml);而在AECOPD组(中位数=8.56U/ml)、DBP组(中位数=7.58U/ml)中无明显升高;在肺癌组中以腺癌组患者升高为最明显,与健康对照组及肺癌鳞癌组、小细胞肺癌组相比有显著性差异(P<0.05)。结论血清CA19-9在肺部多种疾病中都可升高,血清CA19-9水平升高对肺部疾病诊断无特异性。CA19-9高水平升高可能是疾病预后不良的重要指标。

Objective To clarify the relationship between CA19 -9 concentration and several pulmonary diseases by measuring ser- um CA19 -9 level among the patients with several pulmonary diseases. Methods Sixty five healthy subjects and 167 hospitalized pa- tients （including 65 patients with chronic obstructive pulmonary disease with acute exacerbation （AECOPD） , 63 patients of lung cancer, 16 patients of idiopathic pulmonary fibrosis （IPF） , 14 patients with Collagen vascular disease associated pulmonary fibrosis （CDPF） and 9 patients with diffuse panbronchiolitis （DBP）） were enrolled in this study. The serum CA19 - 9 concentration was measured and com- pared between different pulmonary diseases. Results Compared with those with healthy subjects （ median = 5.75U/ml） , the patients with lung cancer had higher CA19 -9 level （median = 29.87U/ml） （P 〈 0.05 ） , the patients with IPF （median = 61.61U/ml） or C DPF （ median = 59.0U/ml） also had the increased CA19 - 9 （ P 〈 0.05 ） , but CA19 - 9 concentrations was not elevated in patients with AE- COPD （median = 8.56U/ml） or DBP （median =7.58U/ml）. However, compared with healthy subjects, only patients with adenocarci- nomia lung cancer had significant increased CA19 - 9, rather than the patients with squamous cell carcinoma or small - cell carcinoma. Conclusion The increased serum CA19 -9 concentration is associated with several pulmonary diseases, not only lung cancer. So the ele- vated serum levels of CA19 -9 does not have specificity for diagnosing pulmonary diseases, but the elevated concentration of CA19 -9 seems to he a bad prognostic independent indicators for lung diseases.