血清CA125升高在系统性红斑狼疮患者中的意义

The Clinical Significance of Serum CA125 in Patients with SLE

目的:探讨血清CA125水平在系统性红斑狼疮中(SLE)中的非肿瘤标志的意义。方法:收集汕头大学第二附属医院与中山大学附属第六医院2016年01月~2017年12月诊断为系统性红斑狼疮的患者(排除怀孕及合并肿瘤患者)共104位,分析CA125水平与SLE患者中相关的临床表现、实验室检查指标之间的关系。结果:(1)SLE疾病中血清CA125水平正常的患者(n=63例)和血清CA125水平异常的患者(n=41例)的基本资料比较,发现浆膜腔积液、尿素氮升高、血肌酐升高、胃肠道受累、病程、肺部感染、C3、IgG、血清白蛋白、尿蛋白、血尿、SLEDAI等指标与CA125水平升高有关(P<0.05)。(2)在多因素的logistic回归分析显示,浆膜腔积液(P=0.01)、血肌酐升高(P=0.01)、血清白蛋白降低(P=0.012)是CA125水平升高的相关因素。(3)浆膜腔积液与血清白蛋白之间存在负相关(r=-0.426,P<0.001)。(4)6例患者在浆膜腔积液与浆膜腔积液消失的两个不同阶段对照比较,发现浆膜腔积液消失后,血清CA125水平均下降(P=0.01)。(5)SLE患者中单纯胸水、单纯腹水、胸水+腹水进行两两比较,其之间的CA125水平比较差异均无统计学意义(P>0.05)。(6)SLE患者的浆膜腔积液中漏出液(n=5例)、渗出液(n=7例)之间的血清CA125水平差异无统计学意义(P>0.05)。结论:(1)血肌酐的升高,血清白蛋白浓度的降低、浆膜腔出现积液是SLE患者血清CA125水平升高的相关因素。(2)浆膜腔渗出液与漏出液的两组患者血清CA125水平均升高,且两组之间升高的幅度差异无统计学意义。(3)CA125水平是SLE患者浆膜腔积液的生物学标志之一。

Objective:To explore the significance of serum CA125 levels as non-tumor markers in systemic lupus erythematosus(SLE).Methods:Retrospectively collected data(serum tumor marker CA125 and related laboratory examination results)of patients which SLE(n=104)in the Second Affiliated Hospital of Shantou University and the Sixth Affiliated Hospital of Sun Yat-sen University during January 2016 to December 2017.The relationship between CA125 levels and clinical manifestations and laboratory tests in these patients was analyzed.Results:(1)The basic data of patients with normal serum CA125 levels(n=63 cases)and patients with abnormal serum CA125 levels(n=41 cases)in SLE disease were compared,found that serous effusion,elevated urea nitrogen,elevated serum creatinine,gastrointestinal involvement,disease course,pulmonary infection,C3,IgG,serum albumin,proteinuria,hematuria and SLEDAI were associated with elevated levels of CA125(P<0.05).(2)By multivariate logistic regression analysis,the presence of serous cavity effusion(P=0.01),increased serum creatinine(P=0.01)and decreased serum albumin(P=0.012)can be regard as an risk factor for elevated CA125 patients.(3)There was a negative correlation(r=-0.426,P<0.001)between serous cavity effusion and serum albumin.(4)Six patients were compared at two different phase of serous effusion and serous effusion disappearance.After the disappearance of serous cavity effusion,the serum CA125 level decreased,and the difference between the two groups was statistically significant.(P=0.01).5.The difference of the serum CA125 lever among the pleural effusion group,abdominal cavity effusion group and pleural combine abdominal cavity effusion group weren't statistically significant(P>0.05).6.The difference of the serum CA125 between the leakage(n=5)and exudate fluid(n=7)weren't statistically significant(P>0.05).Conclusion:(1)Increased serum creatinine,decreased serum albumin concentration,and serous cavity effusion are risk factors for elevated serum CA125 levels.(2)Serum CA125 levels in the two groups of patients with serous exudate and leakage were elevated,and there was no difference in the degree of increasing between the two groups(P>0.05).(3)CA125 level is one of the biological markers of serous effusion in SLE patients.