摘要
目的了解肾功能及维持性血液透析治疗对慢性肾脏疾病(CKD)患者血清癌胚抗原(CEA)、糖蛋白抗原199(CA199)、糖蛋白抗原125(CA125)、甲胎蛋白(AFP)、糖蛋白抗原153(CA153)、糖蛋白抗原724(CA724)、细胞角化素蛋白片段19(CYF1RA21-1)、神经元特异性烯醇化酶(NSE)、鳞癌抗原(SCC)和前列腺特异抗原(PSA)的影响。方法根据肌酐清除率(Ccr)水平将232例未行透析治疗的CKD患者分为Ccr≤30 mL／min、>30且<60 mL／min和≥60 mL／min亚组;选择37例行维持性血液透析的患者及37例Ccr水平与其相近、性别相同的未行维持性血液透析的慢性肾功能衰竭患者作为透析,非透析对照组。测定肿瘤标志物,其中男性患者同时测定PSA。结果不同Ccr亚组间的CEA、CA199、CYFRA21-1、NSE和SCC的差异均有统计学意义(P值均<0．05),且与Ccr呈负相关(r值分别=-0．351 4、-0．209 3、-0．351 9、-0．123 4、-0．236 1, P值均<0．05);而CA125、AFP、CA153和CA724的差异均无统计学意义(P值均>0．05)。透析对照组的血清CA125和NSE均显著高于非透析对照组(P值均<0．05),其余各指标的差异无统计学意义(P值均> 0．05)。结论在透析或非透析的慢性肾功能不全患者中,尤其在肾功能减退严重的患者中,根据血清CEA、CA199、CYFRA21-1、NSE、CA125和SCC表达诊断相应肿瘤时,其假阳性率较肾功能正常及轻度损害者增高,故此类患者可能需要更高的肿瘤标志物正常参考值范围上限;而AFP、CA153、CA724和PSA的特异性与正常人群相同。透析治疗使血清CA125和NSE的诊断价值进一步降低。
Objective Increased serum tumor markers strongly suggest the diagnosis of the corresponding tumors. We studied the effects of Ccr and hemodialysis treatment on the serum concentrations of some tumor markers such as CEA, CA199, CA125, AFP, CA153, CA724, CYFRA21-1, NSE, SCC and PSA in patients with chronic kidney disease. Methods The serum concentrations of those tumor markers in 232 nondialysis patients with chronic kidney diseases were tested. These patients were divided into three groups according to their Ccr： Ccr 30 mL/min group, Ccr 〉30 mL/min and 〈 60 mL/min group, Ccr≥60 mL/min group; with male patients for further PSA testing. In addition, these serum tumor markers in 37 uremic patients on maintenance hemodialysis were compared with 37 chronic nondialysis uremic patients on similar bind levels of Ccr. Results The serum levels of CEA, CA199, CYFRA21-1, NSE and SCC in different Ccr were of significant statistical differences and were also have negative correlations with Ccr. There were no differences in CA125, AFP, CA153, CA724 and PSA among the three groups. The serum levels of CA125 and NSE in dialysis patients were significantly higher than those in the non-dialysis patients. Conclusions The diagnostic value of serum CEA, CA199, CYFRA21-1, NSE, CA125 and SCC for the corresponding tumors were lower in patients with severely damaged kidney function than those with normal or mildly reduced renal function. Dialysis treatment itself may further reduce the diagnostic value of CA125 and NSE.
出处
《上海医学》
CAS
CSCD
北大核心
2007年第2期81-85,共5页
Shanghai Medical Journal
关键词
肿瘤标志物
慢性肾脏病
肌酐清除率
血液透析
诊断价值
Tumor markers
Chronic kidney disease
Creatinine clearance ratel Hemodialysis
Diagnostic value
