类风湿关节炎患者血清肿瘤标志物检测的临床意义

The Clinical Significance of the Tumor Marker Detection in Patients with Rheumatoid Arthritis

目的：观察类风湿关节炎患者血清肿瘤标志物的含量变化及其阳性率,分析肿瘤标志物与RA疾病活动度的关系及肿瘤发生情况。方法：选择2005年1月~2011年12月确诊为类风湿关节炎同时行肿瘤标志物检测的60例住院患者作为RA组,以年龄性别相匹配的健康体检者56例作为对照组。收集类风湿关节炎的疾病活动分数（DAS28）、血沉（ESR）、C-反应蛋白（CRP）、类风湿因子（RF）等资料;肿瘤标志物升高患者均进行胸片、胸部高分辨CT、盆腹部超声或CT、胃镜、肠镜等相关检查明确肿瘤情况,并随访2年以上观察后续肿瘤发生情况。结果：与对照组相比,RA组除CA153外,血清CEA、CA125、CA199数值水平及阳性率均偏高,差异有统计学意义,P〈0.05;但RA组肿瘤标志物升高与疾病活动分数、血沉或C-反应蛋白无相关性,肿瘤标志物升高的患者未发现肿瘤共存依据。结论：类风湿关节炎患者血清CEA、CA125、CA199升高,但并不提示相关肿瘤共存,以后患肿瘤风险是否增加仍需继续随访。

Objective： To observe the change and the positive rate of serum tumor markers in patients with rheumatoid arthritis, and analyze the relationship between tumor markers and RA disease activity and tumor occurrence. Method： From January 2007 to December 2013, 60 hospitalized patients with rheumatoid arthritis and tumor markers were detected were selected as RA group, and 56 healthy individuals with age and sex matched were selected as the control group. Collected rheumatoid arthritis disease activity score （DAS28）, erythrocyte sedimentation rate （ESR）, C-reactive protein （CRP）, and rheumatoid factor （RF） data; the tumor situation of the patients with tumor markers elevation should be confirmed by chest X-ray, chest high resolution CT, pelvic and abdominal ultrasound or CT, endoscopy, and colonoscopy examination, and they were followed up for more than 2 years to observe the subsequent tumor occurrence. Results： Compared with the control group,＇the serum levels and the positive rates of CEA, CA125 and CA199 of the RA group were higher, except the CA153, and the difference was statistically significant, P〈0.05; but the tumor sign elevation of the RA group was not correlated with the disease activity score, erythrocyte sedimentation rate and C-reactiVe protein, the tumor coexisting basis were not found in the patients with tumor marker elevation. Conclusion： Serum CA125, CEA and CA199 were elevated in patients with rheumatoid arthritis, but it does not suggest that the tumor is associated with the development of the tumor. If the risk of cancer will increase need continuing follow up.