Shimon Izhakian, Meir Gagula, Haya Engelstein, Liel Malka, Lev Freidkin, Dror Rosengarten, Mordechai Reuven Kramer
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Vital status and transplant outcomes were retrospectively reviewed as of 31 May 2023. Associations between tumour markers, clinical variables and mortality were analysed using Cox proportional hazards models with competing risk regression.</p><p><strong>Results: </strong>During a median wait time of 17.8 months (IQR: 7.8-44.1), 107 patients received transplants, 38 survived on the list and 137 died while waiting. Multivariable analysis identified higher CA-125 levels (HR 1.03, 95% CI 1.01 to 1.06, p=0.001), older age (HR 1.03, 95% CI 1.01 to 1.06, p=0.001), female gender (HR 1.43, 95% CI 1.01 to 2.04, p<0.04), elevated C-reactive protein (HR 1.17, 95% CI 1.03 to 1.34, p=0.01) and cerebrovascular disease (HR 2.03, 95% CI 1.38 to 2.98, p=0.01) as significant predictors of mortality.</p><p><strong>Conclusion: </strong>Among waitlisted lung transplant candidates with advanced ILD, elevated serum carbohydrate antigen (CA)-125 and CA19-9 levels are associated with higher mortality risk. Routine assessment of these markers may enhance risk stratification for this patient population.</p>","PeriodicalId":9048,"journal":{"name":"BMJ Open Respiratory Research","volume":"12 1","pages":""},"PeriodicalIF":3.4000,"publicationDate":"2025-05-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12097092/pdf/","citationCount":"0","resultStr":"{\"title\":\"Prognostic role of serum CA-125 and CA19-9 in lung transplant candidates with interstitial lung disease: a retrospective cohort study.\",\"authors\":\"Shimon Izhakian, Meir Gagula, Haya Engelstein, Liel Malka, Lev Freidkin, Dror Rosengarten, Mordechai Reuven Kramer\",\"doi\":\"10.1136/bmjresp-2024-002614\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>Advanced interstitial lung disease (ILD) often necessitates lung transplantation, and identifying accessible prognostic markers is essential for effective management. 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引用次数: 0
摘要
背景:晚期间质性肺疾病(ILD)经常需要肺移植,确定可获得的预后标志物是有效治疗的必要条件。然而,血清肿瘤标志物与晚期ILD候选者的生存之间的联系仍未得到充分探讨。目的:评价晚期ILD肺移植患者血清肿瘤标志物水平与长期生存的关系。方法:本研究纳入了282例2012年11月至2021年3月间等待肺移植的终末期ILD患者。在上市前评估基线数据和血清肿瘤标志物水平。回顾性回顾截至2023年5月31日的生命状态和移植结果。使用具有竞争风险回归的Cox比例风险模型分析肿瘤标志物、临床变量和死亡率之间的关联。结果:中位等待时间为17.8个月(IQR: 7.8 ~ 44.1), 107例患者接受移植,38例存活,137例在等待中死亡。多变量分析发现CA-125水平较高(HR 1.03, 95% CI 1.01 ~ 1.06, p=0.001)、年龄较大(HR 1.03, 95% CI 1.01 ~ 1.06, p=0.001)、女性(HR 1.43, 95% CI 1.01 ~ 2.04)。结论:在等待肺移植的晚期ILD患者中,血清碳水化合物抗原(CA)-125和CA19-9水平升高与较高的死亡风险相关。对这些标志物的常规评估可能会加强这类患者的风险分层。
Prognostic role of serum CA-125 and CA19-9 in lung transplant candidates with interstitial lung disease: a retrospective cohort study.
Background: Advanced interstitial lung disease (ILD) often necessitates lung transplantation, and identifying accessible prognostic markers is essential for effective management. However, the link between serum tumour markers and survival in waitlisted lung transplant candidates with advanced ILD remains underexplored.
Objective: To evaluate associations between serum tumour marker levels and long-term survival in lung transplant candidates with advanced ILD.
Methods: This study included 282 patients with end-stage ILD who were waitlisted for lung transplantation from November 2012 to March 2021. Baseline data and serum tumour marker levels were assessed before listing. Vital status and transplant outcomes were retrospectively reviewed as of 31 May 2023. Associations between tumour markers, clinical variables and mortality were analysed using Cox proportional hazards models with competing risk regression.
Results: During a median wait time of 17.8 months (IQR: 7.8-44.1), 107 patients received transplants, 38 survived on the list and 137 died while waiting. Multivariable analysis identified higher CA-125 levels (HR 1.03, 95% CI 1.01 to 1.06, p=0.001), older age (HR 1.03, 95% CI 1.01 to 1.06, p=0.001), female gender (HR 1.43, 95% CI 1.01 to 2.04, p<0.04), elevated C-reactive protein (HR 1.17, 95% CI 1.03 to 1.34, p=0.01) and cerebrovascular disease (HR 2.03, 95% CI 1.38 to 2.98, p=0.01) as significant predictors of mortality.
Conclusion: Among waitlisted lung transplant candidates with advanced ILD, elevated serum carbohydrate antigen (CA)-125 and CA19-9 levels are associated with higher mortality risk. Routine assessment of these markers may enhance risk stratification for this patient population.
期刊介绍:
BMJ Open Respiratory Research is a peer-reviewed, open access journal publishing respiratory and critical care medicine. It is the sister journal to Thorax and co-owned by the British Thoracic Society and BMJ. The journal focuses on robustness of methodology and scientific rigour with less emphasis on novelty or perceived impact. BMJ Open Respiratory Research operates a rapid review process, with continuous publication online, ensuring timely, up-to-date research is available worldwide. The journal publishes review articles and all research study types: Basic science including laboratory based experiments and animal models, Pilot studies or proof of concept, Observational studies, Study protocols, Registries, Clinical trials from phase I to multicentre randomised clinical trials, Systematic reviews and meta-analyses.