A correlation study of serum tumor markers with systemic lupus erythematosus-associated interstitial lung disease

Abstract

Abstract Background: Systemic lupus erythematosus-associated interstitial lung disease (SLE-ILD) is one of the manifestations of SLE involvement of the lung, and currently, serum markers are lacking for its early prediction. In this study, we investigated the clinical significance of serum tumor markers (TM) in SLE-ILD to further analyze the potential correlation of serum TM with SLE affected of tissues and organs. Methods: Medical records of SLE patients from Sichuan Provincial People's Hospital ＆ University of Electronic Science and Technology of China were retrospectively reviewed. Serum TM including carcinoembryonic antigen (CEA), carbohydrate antigens (CA125, CA15-3, CA19-9), squamous cell carcinoma antigen (SCC), cytokeratin-19-fragment (CYFRA21-1), neuron-specific enolase (NSE), ferritin (FER) from the peripheral blood of SLE patients with or without ILD were compared and analyzed, to investigate their relevance and clinical value in patients with SLE-ILD. Results: A total of 927 patients eligible for the diagnosis of SLE were enrolled in this study, and 386 patients with SLE were finally included, including 64 patients with SLE-ILD. Age, and levels of erythrocyte sedimentation rate (ESR), serum lactate dehydrogenase (LDH), and serum creatine kinase (CK) in patients with SLE-ILD were higher than those with SLE (P<0.05). Patients with SLE-ILD had higher serum levels of CEA, CA125, CA15-3, CA19-9, SCC, CYFRA21-1, and FER compared to SLE patients. Results of multivariate regression showed that age [OR=1.038, 95% CI=(1.004,1.074)], CA15-3 [OR=1.099, 95% CI=(1.039,1.162)], and CA19-9 [OR=1.032, 95% CI=(1.005,1.059)] were predictors of SLE-ILD (P <0.05). Among the monitored serum TM, CA125 and CA15-3 possessed good predictive values (area under the receiver operating characteristic curve (AUC) was 0.7 and 0.722, respectively, P<0.05); serum SCC and CYFRA21-1 were moderately positively correlated with serum creatinine (Cr) levels (r value was 0.562 and 0.713, respectively, P<0.001). Conclusions: Serum CA125, CA15-3, and CA19-9 can serve as clinical predictive markers for SLE-ILD. In addition to lungs, serum SCC, CYFRA21-1 and FER detected in tumor-related markers may also related to kidney involvement of SLE.It is recommended to strengthen the monitoring and investigation of serum TM in patients with SLE-ILD to discover its potential clinical value.