血清肺癌标志物水平与脓毒症病情和预后的相关性

Correlation of serum lung cancer biomarkers with the severity and prognosis of sepsis

目的 探讨5种常用的肺癌标志物[血清鳞状上皮细胞癌抗原(SCC)、癌胚抗原(CEA)、细胞角蛋白19可溶性片段(Cyfra21-1)、神经元特异性烯醇化酶(NSE)、胃泌素释放肽前体(proGRP)]水平与脓毒症病情严重程度及临床转归的相关性。方法 选择2016年1月-2019年12月北京大学第三医院内科重症监护病房(ICU)住院的88例脓毒症患者。分析上述肺癌标志物与序贯器官衰竭(SOFA)评分、急性生理与慢性健康状况(APACHE)Ⅱ评分的相关性。并利用血清肺癌标志物水平建立脓毒症预后危险标志物评分。结果 88例脓毒症患者中脓毒性休克占23.9%,住院病死率为35.2%。血清SCC、CEA、Cyfra21-1、NSE和proGRP水平升高的患者分别占72.9%、53.2%、73.2%、51.9%和36.2%。多因素Logistic回归分析表明SOFA评分(OR=1.435,P=0.020)、预后危险标志物评分(OR=3.336,P=0.045)和年龄(OR=1.115,P=0.045)是脓毒症患者住院死亡的独立危险因素。结论 约半数以上的脓毒症患者血清肺癌标志物水平升高,且与病情严重程度相关。预后危险标志物评分是脓毒症患者死亡的独立危险因素之一。

OBJECTIVE To investigate the correlation between serum levels of 5 commonly used lung cancer biomarkers [squamous cell carcinoma antigen(SCC), carcinoembryonic antigen(CEA), soluble cytokeratin 19 fragment(Cyfra21-1), neuron-specific enolase(NSE), pro-gastrin releasing peptide(proGRP)] and the severity and clinical outcome of sepsis. METHODS A total of 88 patients with sepsis hospitalized in the internal intensive care unit(ICU) of Peking University Third Hospital from Jan 2016 to Dec 2019 were selected. The correlations between the lung cancer markers and the SOFA score, and APACHE II score were analyzed. Prognosis risk biomarker score was established according to the levels of the five serum lung cancer biomarkers. RESULTS Septic shock accounted for 23.9% of 88 sepsis patients, and the hospital mortality was 35.2%. Patients with increased serum levels of SCC, CEA, Cyfra21-1, NSE and proGRP accounted for 72.9%, 53.2%, 73.2%, 51.9%, and 36.2% patients, respectively. Multivariate Logistic regression analysis showed that the SOFA score(OR=1.435, P=0.020), prognosis risk biomarker score(OR=3.336, P=0.045) and age(OR= 1.115, P= 0.045) were independent risk factors for hospitalized mortality of sepsis patients. CONCLUSION The levels of serum lung cancer markers were elevated in more than half of the patients with sepsis, which were related to the severity of the disease. The prognosis risk biomarker score was one of the independent risk factors for hospitalized mortality of sepsis patients.