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目的验证非肿瘤的慢性肾脏病(CKD)患者是否存在血清肿瘤标志物表达的改变并分析影响其改变的相关因素。方法2005年3月至6月对复旦大学附属中山医院的232例肾内科住院患者,分别根据内生肌酐清除率(Ccr)、蛋白尿(Upro)和血清白蛋白(Salb)表达分组,采用单因素分析了解其与血清肿瘤标志物是否相关。利用多元回归分析了解年龄、Ccr、浆膜腔积液、Upro和Salb对血清肿瘤标志物是否存在独立影响。结果CEA、CA199、NSE和SCC表达在不同Ccr组间和CA199、CA125、NSE和SCC表达在不同Salb组间以及CA125、NSE和SCC表达在不同Upro组间,均值差异均有统计学意义。年龄为CEA和PSA表达升高的危险因素(RF);浆膜腔积液为CA125表达升高的RF;Ccr的下降为CA125和SCC升高的RF;Upro的增加为SCC升高的RF;Salb表达的下降分别为CA199、CA125和NSE升高的RF。结论CKD患者中根据血清肿瘤标志物诊断相应肿瘤时,须结合患者年龄及是否合并有大量蛋白尿、低蛋白血症、浆膜腔积液和肾功能不全等因素。
Objective To verify the existence of changes of serum tumor markers in patients with non-tumor chronic kidney disease (CKD) and analyze the related factors that affect the changes. Methods A total of 232 inpatients with nephrology in Zhongshan Hospital Affiliated to Fudan University from March 2005 to June 2005 were divided into groups according to the expression of endogenous creatinine clearance (Ccr), proteinuria (Upro) and serum albumin (Salb) Factor analysis to understand whether it is correlated with serum tumor markers. Multivariate regression analysis was performed to determine whether age, Ccr, serosal effusion, Upro, and Salb have an independent effect on serum tumor markers. Results The expressions of CEA, CA199, NSE and SCC were significantly different between different Ccr groups and between CA199, CA125, NSE and SCC in different Salb groups and between CA125, NSE and SCC in different Upro groups. Age is a risk factor for elevated CEA and PSA (PSA); serosal effusion is elevated RF for CA125 expression; decreased Ccr is elevated RF for CA125 and SCC; increased for Upro is RF for SCC elevation; The decrease of Salb expression was elevated RF of CA199, CA125 and NSE, respectively. Conclusion CKD patients based on serum tumor markers in the diagnosis of the corresponding tumor, the patient should be combined with age and whether there is a large number of proteinuria, hypoproteinemia, serous fluid and renal insufficiency and other factors.