{"title":"血清癌胚抗原升高与过敏性支气管肺曲霉病/真菌病的临床相关性：一项多中心回顾性研究","authors":"Huan Ge, Runjin Cai, Xuemei Chen, Bin Liu, Xinyue Hu, Shuanglinzi Deng, Hui Li, Lixue Dai, Jiale Tang, Huan Tang, Xiaoxiao Gong, Chendong Wu, Guo Wang, Guotao Li, Bing Liu, Jun Wang, Yuling Tang, Xiaozhao Li, Juntao Feng","doi":"10.2147/JAA.S494250","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>Allergic bronchopulmonary aspergillosis/mycosis (ABPA/M) is a complex non-infectious pulmonary benign disease characterized by an immune response against aspergillus/fungus. Carcinoembryonic antigen (CEA), typically recognized as a tumor marker, also elevated in certain benign diseases. Few studies on ABPA/M cases presenting with elevated serum CEA levels have been reported.</p><p><strong>Patients and methods: </strong>A cohort of 115 patients diagnosed as ABPA/M were divided into two groups (CEA normal and CEA elevated). The characteristics of ABPA/M patients in terms of its demographic profile, clinical symptoms, pertinent clinical laboratory examinations were analyzed. Levels of cytokines (IL-4, IL-5, GM-CSF, IFN-γ) were analyzed by enzyme-linked immunosorbent assay. Comparative evaluation included pre-therapy and post-treatment eosinophil count and total IgE level, to evaluate therapeutic disparities between the two groups.</p><p><strong>Results: </strong>Among 115 cases of ABPA/M, 32 exhibited elevated serum CEA levels above baseline and 83 were normal. ABPA/M patients with elevated serum CEA tended to be younger (50, IQR [43-56] years vs 59, IQR [47-68] years; P < 0.05) with superior pulmonary function (FEV1/FVC ratio, 65.1% (44.2, 79.6) vs 79.1% (65.2, 84.2), P < 0.05), and showed marginally higher baseline levels of the total IgE (P < 0.05), blood eosinophils counts and ratios (P < 0.01) compared to those with normal CEA. Higher serum levels of IL-4, IL-5, GM-CSF and IFN-γ in ABPA/M patients with elevated serum CEA levels were observed (P < 0.0001). After treatment (at 12w), compared to ABPA/M patients with normal serum CEA, the decrease in eosinophil count and total IgE levels was less pronounced in ABPA/M patients with elevated serum CEA eosinophil count, 523±481.66 vs 267±200.68, P < 0.05; total IgE, 619±680.47 vs 263±400.90, P < 0.05), which indicates a poor response to treatment.</p><p><strong>Conclusion: </strong>Monitoring serum CEA levels may serve as a supplementary tool in the clinical management of ABPA/M patients.</p>","PeriodicalId":15079,"journal":{"name":"Journal of Asthma and Allergy","volume":"17 ","pages":"1313-1323"},"PeriodicalIF":3.7000,"publicationDate":"2024-12-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11683200/pdf/","citationCount":"0","resultStr":"{\"title\":\"Clinical Relevance of Elevated Serum Carcinoembryonic Antigen in Allergic Bronchopulmonary Aspergillosis/Mycosis: A Multicenter Retrospective Study.\",\"authors\":\"Huan Ge, Runjin Cai, Xuemei Chen, Bin Liu, Xinyue Hu, Shuanglinzi Deng, Hui Li, Lixue Dai, Jiale Tang, Huan Tang, Xiaoxiao Gong, Chendong Wu, Guo Wang, Guotao Li, Bing Liu, Jun Wang, Yuling Tang, Xiaozhao Li, Juntao Feng\",\"doi\":\"10.2147/JAA.S494250\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>Allergic bronchopulmonary aspergillosis/mycosis (ABPA/M) is a complex non-infectious pulmonary benign disease characterized by an immune response against aspergillus/fungus. Carcinoembryonic antigen (CEA), typically recognized as a tumor marker, also elevated in certain benign diseases. Few studies on ABPA/M cases presenting with elevated serum CEA levels have been reported.</p><p><strong>Patients and methods: </strong>A cohort of 115 patients diagnosed as ABPA/M were divided into two groups (CEA normal and CEA elevated). The characteristics of ABPA/M patients in terms of its demographic profile, clinical symptoms, pertinent clinical laboratory examinations were analyzed. Levels of cytokines (IL-4, IL-5, GM-CSF, IFN-γ) were analyzed by enzyme-linked immunosorbent assay. Comparative evaluation included pre-therapy and post-treatment eosinophil count and total IgE level, to evaluate therapeutic disparities between the two groups.</p><p><strong>Results: </strong>Among 115 cases of ABPA/M, 32 exhibited elevated serum CEA levels above baseline and 83 were normal. ABPA/M patients with elevated serum CEA tended to be younger (50, IQR [43-56] years vs 59, IQR [47-68] years; P < 0.05) with superior pulmonary function (FEV1/FVC ratio, 65.1% (44.2, 79.6) vs 79.1% (65.2, 84.2), P < 0.05), and showed marginally higher baseline levels of the total IgE (P < 0.05), blood eosinophils counts and ratios (P < 0.01) compared to those with normal CEA. Higher serum levels of IL-4, IL-5, GM-CSF and IFN-γ in ABPA/M patients with elevated serum CEA levels were observed (P < 0.0001). After treatment (at 12w), compared to ABPA/M patients with normal serum CEA, the decrease in eosinophil count and total IgE levels was less pronounced in ABPA/M patients with elevated serum CEA eosinophil count, 523±481.66 vs 267±200.68, P < 0.05; total IgE, 619±680.47 vs 263±400.90, P < 0.05), which indicates a poor response to treatment.</p><p><strong>Conclusion: </strong>Monitoring serum CEA levels may serve as a supplementary tool in the clinical management of ABPA/M patients.</p>\",\"PeriodicalId\":15079,\"journal\":{\"name\":\"Journal of Asthma and Allergy\",\"volume\":\"17 \",\"pages\":\"1313-1323\"},\"PeriodicalIF\":3.7000,\"publicationDate\":\"2024-12-25\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11683200/pdf/\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Journal of Asthma and Allergy\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.2147/JAA.S494250\",\"RegionNum\":3,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"2024/1/1 0:00:00\",\"PubModel\":\"eCollection\",\"JCR\":\"Q2\",\"JCRName\":\"ALLERGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of Asthma and Allergy","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.2147/JAA.S494250","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2024/1/1 0:00:00","PubModel":"eCollection","JCR":"Q2","JCRName":"ALLERGY","Score":null,"Total":0}
引用次数: 0
摘要
背景：过敏性支气管肺曲霉病/真菌病（ABPA/M）是一种复杂的非传染性肺部良性疾病，其特征是对曲霉/真菌的免疫反应。癌胚抗原（CEA）通常被认为是肿瘤标志物，在某些良性疾病中也升高。很少有ABPA/M患者血清CEA水平升高的研究报道。患者与方法：将115例确诊为ABPA/M的患者分为CEA正常组和CEA升高组。分析ABPA/M患者的人口学特征、临床症状和相关的临床实验室检查。采用酶联免疫吸附法分析细胞因子（IL-4、IL-5、GM-CSF、IFN-γ）水平。比较评价包括治疗前和治疗后嗜酸性粒细胞计数和总IgE水平，以评价两组治疗差异。结果：115例ABPA/M患者中，32例血清CEA水平高于基线，83例正常。血清CEA升高的ABPA/M患者倾向于年轻化(50，IQR[43-56]岁vs 59， IQR[47-68]岁；P < 0.05)，肺功能优越(FEV1/FVC比值，65.1% (44.2,79.6)vs 79.1% (65.2, 84.2), P < 0.05)，总IgE基线水平（P < 0.05）、血嗜酸性粒细胞计数和比值（P < 0.01）均高于CEA正常组。血清CEA水平升高的ABPA/M患者血清IL-4、IL-5、GM-CSF和IFN-γ水平升高（P < 0.0001）。治疗后（12w），与血清CEA正常的ABPA/M患者相比，血清CEA升高的ABPA/M患者嗜酸性粒细胞计数和总IgE水平下降较不明显，分别为523±481.66 vs 267±200.68,P < 0.05；总IgE(619±680.47 vs 263±400.90,P < 0.05)，提示治疗反应较差。结论：监测血清CEA水平可作为ABPA/M患者临床管理的辅助手段。
Clinical Relevance of Elevated Serum Carcinoembryonic Antigen in Allergic Bronchopulmonary Aspergillosis/Mycosis: A Multicenter Retrospective Study.
Background: Allergic bronchopulmonary aspergillosis/mycosis (ABPA/M) is a complex non-infectious pulmonary benign disease characterized by an immune response against aspergillus/fungus. Carcinoembryonic antigen (CEA), typically recognized as a tumor marker, also elevated in certain benign diseases. Few studies on ABPA/M cases presenting with elevated serum CEA levels have been reported.
Patients and methods: A cohort of 115 patients diagnosed as ABPA/M were divided into two groups (CEA normal and CEA elevated). The characteristics of ABPA/M patients in terms of its demographic profile, clinical symptoms, pertinent clinical laboratory examinations were analyzed. Levels of cytokines (IL-4, IL-5, GM-CSF, IFN-γ) were analyzed by enzyme-linked immunosorbent assay. Comparative evaluation included pre-therapy and post-treatment eosinophil count and total IgE level, to evaluate therapeutic disparities between the two groups.
Results: Among 115 cases of ABPA/M, 32 exhibited elevated serum CEA levels above baseline and 83 were normal. ABPA/M patients with elevated serum CEA tended to be younger (50, IQR [43-56] years vs 59, IQR [47-68] years; P < 0.05) with superior pulmonary function (FEV1/FVC ratio, 65.1% (44.2, 79.6) vs 79.1% (65.2, 84.2), P < 0.05), and showed marginally higher baseline levels of the total IgE (P < 0.05), blood eosinophils counts and ratios (P < 0.01) compared to those with normal CEA. Higher serum levels of IL-4, IL-5, GM-CSF and IFN-γ in ABPA/M patients with elevated serum CEA levels were observed (P < 0.0001). After treatment (at 12w), compared to ABPA/M patients with normal serum CEA, the decrease in eosinophil count and total IgE levels was less pronounced in ABPA/M patients with elevated serum CEA eosinophil count, 523±481.66 vs 267±200.68, P < 0.05; total IgE, 619±680.47 vs 263±400.90, P < 0.05), which indicates a poor response to treatment.
Conclusion: Monitoring serum CEA levels may serve as a supplementary tool in the clinical management of ABPA/M patients.
期刊介绍：
An international, peer-reviewed journal publishing original research, reports, editorials and commentaries on the following topics: Asthma; Pulmonary physiology; Asthma related clinical health; Clinical immunology and the immunological basis of disease; Pharmacological interventions and new therapies.
Although the main focus of the journal will be to publish research and clinical results in humans, preclinical, animal and in vitro studies will be published where they shed light on disease processes and potential new therapies.
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