摘要
目的检测肾病综合征患者血清中常见肿瘤标志物的浓度,探讨常见肿瘤标志物与肾病综合征及其不同病理分型的关系,为临床诊断和鉴别良性和恶性疾病提供理论依据。方法选择2015年5月—2016年6月武汉大学人民医院肾病内科住院的肾病综合征患者111例,男性58例,平均(60±13)岁;女性53例,平均(61±10)岁。肝肾功能指标、唾液酸(SA)和α-L-岩藻糖苷酶(AFU)采用西门子全自动生化分析仪ADVIA 2400检测,肿瘤标志物糖类抗原72-4(CA72-4)、细胞角蛋白19片段21-1(CYFRA21-1)和神经元特异性烯醇化酶(NSE)采用罗氏全自动化学发光免疫分析仪E 601检测,鳞状细胞癌抗原(SCC)采用雅培全自动发光免疫分析仪I 2000检测,α-甲胎蛋白(AFP)、CA125、CA19-9和癌胚抗原(CEA)采用西门子全自动发光免疫分析仪Advia Centaur XP检测。结果肝肾功能指标ALB、GLB和Cr在健康对照组和肾病综合征患者组间比较,差异均有统计学意义(t_(ALB)=-23.29,t_(GLB)=-8.88,t_(Cr)=7.16,均P<0.05),而肝功能指标ALT、AST在健康对照组和肾病综合征患者组间比较,差异无统计学意义(t_(ALT)=1.39,t_(AST)=1.59,P>0.05)。CA72-4,CA125,CA19-9,CYFRA21-1,SA,SCC和NSE指标在健康对照组和肾病综合征患者组间比较,差异均有统计学意义(t_(CA72-4)=2.31,t_(CA12)5=9.86,t_(CA19-9)=7.86,t_(CYFRA21-1)=10.34,t_(SA)=3.36,t_(SCC)=5.16,t_(NSE)=6.73;均P<0.05),而AFP,AFU和CEA指标在健康对照组和肾病综合征患者组间比较,差异均无统计学意义(t_(AFP)=0.25,t_(AFU)=-1.60,t_(CEA)=-0.08;均P>0.05)。CYFRA21-1指标在不同病理类型的肾病综合征组间比较,差异有统计学意义(FCYFRA21-1=3.53,P<0.05),进一步对CYFRA21-1进行组间两两比较,结果发现CYFRA21-1在膜性肾病和系膜增生性肾小球肾炎组间比较,差异有统计学意义(t=3.15,P<0.01)。结论血清肿瘤标志物在肾病综合征患者中较高水平并且CUFR21-1与病理类型具有一定关系,可为临床诊断、鉴别肾病综合征和减少误诊提供帮助。
[Objective] To detect the concentrations of serum tumor markers in patients with nephrotic syndrome,explore the relationship between the common tumor markers and nephrotic syndrome and its pathological type,and provided a theoretical basis for clinical diagnosis and differentiation of benign and malignant diseases.[Methods] From May 2015 to June 2016,111 cases with nephrotic syndrome were randomly selected from Renmin Hospital of Wuhan University,including 58 male cases with average age of （60±13） years old and 53 female cases with average age of （61±10） years old.Liver and kidney function parameters,sialic acid （SA） and α-L-fucosidase （AFU） were detected by the Siemens ADVIA 2400 automatic biochemical analyzer.As for the tumor markers,carbohydrate antigen 72-4 （CA72-4）,cytokeratin-19 fragment 21-1 （CYFRA21-1） and neuron specific enolase （NSE） were detected by automatic analyzer E 601,squamous cell carcinoma antigen （SCC） was detected by automatic analyzer Ⅰ 2000,while α-fetoprotein （AFP）,carbohydrate antigen 125 （CA125）,carbohydrate antigen 19-9 （CA19-9） and carcinoembryonic antigen （CE） were detected by automatic analyzer Advia Centaur XP.[Results] The differences in levels of ALB,GLB and Cr were statistically significant between the health control group and nephrotic syndrome group （tALB=-23.29,tGLB=-8.88,tCr=7.16,all P〈0.05）,while there were not statistically significant differences in levels of ALT and AST between two groups （tALT=1.39,tAST=1.59,both P〉0.05）.The differences in levels of CA72-4,CA125,CA19-9,CYFRA21-1,SA,SCC and NSE were statistically significant between the health control group and nephrotic syndrome group （tCA72-4=2.31,tCA125=9.86,tCA19-9=7.86,tCYFRA21-1=10.34,tSA=3.36,tSCC=5.16,tNSE=6.73,all P〈0.05）,while there were not statistically significant differences in levels of AFP,AFU and CEA between two groups （tAFP=0.25,tAFU=-1.60,tCEA=-0.08,all P〉0.05）.The difference in level of CYFRA21-1 was statistically significant among nephrotic syndrome groups in different pathological types （FCYFRA21-1=3.53,P〈0.05）.And there was statistically significant difference in level of CYFRA21-1 between membranous nephropathy group and mesangial proliferative glomerulonephritis group （t=3.15,P〈0.01）.[Conclusion] The concentrations of serum tumor markers are high nephrotic syndrome patients and CYFRA21-1 has a certain relationship with pathological type,which be used as a reference index of clinical diagnosis,differential diagnosis of nephrotic syndrome and reduction of misdiagnosis.
出处
《职业与健康》
CAS
2017年第13期1754-1757,1761,共5页
Occupation and Health
关键词
肿瘤标志物
肾病综合征
病理分型
Tumor markers
Nephrotic syndrome
Pathological type
