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目的检测慢性肾脏疾病(CKD)患者常见肿瘤标志物的水平,探讨常见肿瘤标志物与慢性肾脏疾病不同分期的关系。方法随机选取2014年6月—2015年12月武汉大学人民医院肾病内科住院患者200例,分别检测血清常见肿瘤标志物人类附睾蛋白4(HE4)、糖类抗原72-4(CA72-4)、细胞角蛋白19片段(CYFRA21-1)、神经元特异性烯醇化酶(NSE)、鳞状细胞癌抗原(SCC)、α-甲胎蛋白(AFP)、糖类抗原125(CA125)、糖类抗原19-9(CA19-9)和癌胚抗原(CEA)水平,其中HE4,CA72-4,CYFRA21-1和NSE检测应用罗氏全自动化学发光免疫分析仪E601,SCC检测应用雅培全自动发光免疫分析仪I2000,AFP、CA125、CA19-9和CEA检测采用西门子全自动发光免疫分析仪Advia Centaur XP。结果肿瘤标志物在CKD不同分期组和健康组间进行比较发现,HE4、CA72-4、SCC、CYFRA21-1、CA125、CA19-9和CEA在CKD不同分期组间的差异有统计学意义(F_(HE4)=96.06,F_(CA72-4)=2.59,F_(SCC)=14.88,F_(CYFRA21-1)=5.10,F_(CA125)=8.94,F_(CA19-9)=2.68,F_(CEA)=2.88,均P<0.05),而NSE和AFP在CKD不同分期间差异无统计学意义(F_(NSE)=0.686,F_(AFP)=1.39,均P>0.05)。对CKD5期患者透析组和未透析组间肿瘤标记物进行比较,结果发现仅HE4(t=3.09,P<0.05)和CEA(t=2.65,P<0.05)在两组间比较,差异有统计学意义;而CA72-4,SCC,CYFRA21-1,NSE,AFP,CA125和CA19-9在两组间比较,差异无统计学意义(|t|<1.2,均P>0.05)。结论 CKD分期和血液透析影响肿瘤标志物的浓度,可作为临床CKD诊断、减少误诊的参考指标。
Objective To detect the levels of common tumor markers in patients with chronic kidney disease (CKD) and to explore the relationship between common tumor markers and different stages of chronic kidney disease. Methods A total of 200 inpatients with nephrology in Wuhan University People’s Hospital from June 2014 to December 2015 were selected randomly to detect the serum levels of human epididymal protein 4 (HE4), carbohydrate antigen 72-4 (CA72-4) Cytokeratin 19 fragment (CYFRA21-1), neuron specific enolase (NSE), squamous cell carcinoma antigen (SCC), alpha-fetoprotein (AFP), carbohydrate antigen 125 Antigen 19-9 (CA19-9) and carcinoembryonic antigen (CEA) were detected by ELISA. The detection of HE4, CA72-4, CYFRA21-1 and NSE was performed with Roche automated chemiluminescence immunoassay analyzer E601. SCC detection was performed using Abbott automatic luminescence immunoassay Analyzers I2000, AFP, CA125, CA19-9 and CEA tests were performed on the Advia Centaur XP, a fully automated immunoassay analyzer from Siemens. Results The comparison of tumor markers in different stages of CKD and healthy group showed that there was significant difference in the different stages of CKD among HE4, CA72-4, SCC, CYFRA21-1, CA125, CA19-9 and CEA (F_ (CE4) = 96.06, F_ (CA72-4) = 2.59, F SCC = 14.88, F_ (CYFRA21-1) = 5.10, F_ (CA125) = 8.94, F_ (CA19-9) = 2.68, ) = 2.88, all P <0.05). There was no significant difference between NSE and AFP in different stages of CKD (F_ (NSE) = 0.686, F_ (AFP) = 1.39, all P> 0.05). Comparison of tumor markers between dialysis group and non-dialysis group in CKD5 patients showed that there was statistical difference between the two groups only HE4 (t = 3.09, P <0.05) and CEA (t = 2.65, P <0.05) However, no significant difference was found between CA72-4, SCC, CYFRA21-1, NSE, AFP, CA125 and CA19-9 (| t | <1.2, all P> 0.05). Conclusion CKD staging and hemodialysis affect the concentration of tumor markers, which can be used as a reference for diagnosis and reduction of misdiagnosis of clinical CKD.