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目的 提高对CA19 9显著升高的特发性肺纤维化 (IPF)的认识 ,评价CA19 9的升高与IPF进展的相关性。方法 对 1例 79岁男性血清CA19 9显著升高IPF患者的临床资料进行分析 ,并复习相关的文献进行分析。结果 本例患者血清CA19 9进行性升高 ,从最初的 899U ml升高至 10个月后的 385 4U ml ,经过反复全面检查和 10个月随访 ,未发现恶性肿瘤和其他疾病的证据 ,CA19 9的进行性升高与肺纤维化程度的进展正相关。通过检索Medline文献 ,发现日本有 6例血清CA19 9升高 >10 0 0U ml的类似病例报道 ,通过免疫组化分析发现重度纤维化区域CA19 9呈阳性反应。结论 作为消化道恶性肿瘤标志物的CA19 9显著升高可见于IPF患者 ,可能提示肺纤维化的进展 ,但不提示疾病的活动性 ,是预后不良的标志
OBJECTIVE: To improve the understanding of significantly elevated idiopathic pulmonary fibrosis (CAF) in CA19 9 and to evaluate the association between elevated CA19 9 and IPF progression. Methods The clinical data of a 79-year-old male with elevated serum CA19 9 in IPF were analyzed and the related literatures were reviewed. Results The serum CA19 9 level increased from the initial 899U ml to 385 4U ml after 10 months. The evidence of malignant tumor and other diseases was not found after repeated comprehensive examination and 10-month follow-up. CA19 The progressive increase in 9 is positively correlated with the progression of pulmonary fibrosis. By searching the Medline literature, we found that 6 cases of similar cases of serum CA19 9> 10 000 U ml were reported in Japan, and positive CA19 9 was found in severe fibrosis area by immunohistochemistry. Conclusions The significant elevation of CA19 9, a marker of gastrointestinal malignancies, can be seen in patients with IPF and may indicate the progression of pulmonary fibrosis, but does not indicate disease activity, which is a sign of poor prognosis