慢性肾脏病患者血清肿瘤标志物水平的改变及危险因素分析

    Changes of serum tumor marker levels and analysis of risk factors in patients with chronic kidney disease

    • 摘要: 目的 探讨血清肿瘤标志物在慢性肾脏病(chronic kidney diease,CKD)患者中的表达变化,并分析影响其改变的危险因素。方法 收集徐州医科大学附属医院427例CKD患者和420例健康体检者的血清肿瘤标志物包括甲胎蛋白(α-fetoprotein,AFP)、癌胚抗原(carcinoembryonic antigen,CEA)、CA125、CA199、CA153、总前列腺特异性抗原(total prostate specific antigen,TPSA)、血清白蛋白(albumin,Alb)、Scr、Hb、年龄、肾小球滤过率等指标,比较两组间差异。通过单因素分析筛出导致CKD患者肿瘤标志物改变的相关因素,并进一步利用多因素Logistic回归分析明确肿瘤指标升高的危险因素。结果 CKD组患者血清TPSA水平和健康对照组比较,差异无统计学意义(P>0.05),AFP水平低于健康对照组,差异有统计学意义(P<0.01),CEA、CA125、CA199、CA153水平高于健康对照组,差异有统计学意义(P<0.01)。Logistic回归分析显示肾小球滤过率下降是CEA升高危险因素,Alb、Hb下降是CA125升高的危险因素,Alb下降是CA199、CA153升高的危险因素,年龄增大是TPSA升高的危险因素。结论 TPSA在CKD患者中的应用价值和正常人群相同。在根据血清肿瘤指标诊断相关肿瘤时,须结合患者年龄、肾功能、Alb、Hb水平等因素综合分析。

       

      Abstract: Objective To investigate whether the expression of serum tumor markers in patients with chronic kidney disease(CKD)has changed,and to analyze the risk factors influencing the changes. Methods The serum tumor markersincluding α-fetoprotein(AFP),carcinoembryonic antigen(CEA),CA125,CA199,CA153,TPSA,albumin(Alb),serum creatinine,hemoglobin levels,age and glomerular filtration rate(GFR)of 427 CKD patients and 420 healthy medical examiners from the Affiliated Hospital of Xuzhou Medical University were collected and compared for differences between the two groups.The relevant factors that lead to changes in tumor markers in patients with CKD were screened out by univariate analysis,and multi-factor logistic regression analysis were used to identify risk factors for elevated tumor indicators. Results There was no significant difference in serum TPSA between the CKD group and the healthy control group(P<0.05).The AFP level was lower than that of the healthy control group,and the difference was statistically significant(P<0.01).The levels of CEA,CA125,CA199,and CA153 were higher than those in the healthy control group,with statistically significantdifferences(P<0.01).Logistic regression analysis showed that decreased glomerular filtration rate was a risk factor for CEA elevation,serum albumin and hemoglobin decline were risk factors for CA125 elevation,serum albumin decrease was a risk factor for CA199 and CA153 elevation,and age was a risk factor for elevated TPSA. Conclusions The application value of TPSA in CKD patients is the same as that in the normal population.In the diagnosis of related tumors based on serum tumor indicators,a comprehensive analysis must be done in conjunction with factors such as patients' age,renal function,serum albumin,and hemoglobin levels.

       

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