Values of serum carbohydrate antigen 125,cytoskeleton-associated protein 4 and squamous cell carcinoma antigen to the diagnosis of lung cancer in patients with idiopathic pulmonary fibrosis
Objective To investigate the changes of serum carbohydrate antigen 125(CA125),cytoskeleton-associated protein 4(CKAP4)and squamous cell carcinoma antigen(SCCA)levels in patients with idiopathic pulmonary fibrosis(IPF)combined with lung cancer,and to investigate their values to the diagnosis of lung cancer.Methods From February 2018 to November 2022,31 patients with IPF-combined with lung cancer(observation group)and 185 patients with IPF without lung cancer(control group)were collected the fasting elbow venous blood to detect the serum levels of CA125 and SCCA by chemiluminescence immunoassay and to detect the serum level of CKAP4 by ELISA in Henan Provincial Chest Hospital.The gender ratio,age,body mass index,smoking habits,comorbidities(hypertension,diabetes),and the serum levels of CA125,SCCA and CKAP4 were compared between two groups.The influencing factors of lung cancer in IPF patients were analyzed by multivariate logistic regression.ROC curve was plotted to evaluate the efficiencies of serum CA125,CKAP4 and SCCA on the diagnosis of lung cancer in IPF patients.According to clinical stage,observation group was divided into stage Ⅰ-Ⅱ group(n=7),stage Ⅲ group(n=15)and stage Ⅳ group(n=9),and the serum levels of CA125,SCCA and CKAP4 were compared among three groups.Results(1)The patients were older in observation group[(59.46±12.15)years]than those in control group[(49.67±9.48)years],the male ratio,the proportion of smoking habits,and the levels of serum CA125,CKAP4 and SCCA were higher in observation group[80.65％,74.19％,(48.45±9.82)u/mL,(546.33±113.62)ng/L,(6.69±1.24)μg/L]than those in control group[58.92％,35.14％,(38.69±7.51)u/mL,(415.27±100.58)ng/L,(5.35±0.94)μg/L](P＜0.05),and there were no significant differences in the body mass index and proportions of comorbidities(hypertension,diabetes)between two groups(P＞0.05).(2)The serum CA125(OR=3.803,95％CI:1.756-8.238,P＜0.001),CKAP4(OR=4.178,95％CI:2.534-6.887,P＜0.001),and SCCA(OR=4.229,95％CI:2.142-8.349,P＜0.001)were the influencing factor of lung cancer in IPF patients.(3)When the optimal cut-off values of serum CA125,CKAP4 and SCCA were 44.71 u/mL,452.04 ng/L and 6.08 μg/L,the AUCs for diagnosing lung cancer in IPF patients were 0.790(95％CI:0.730-0.843,P＜0.001),0.799(95％CI:0.739-0.850,P＜0.001)and 0.822(95％CI:0.764-0.870,P＜0.001),the sensitivities were 74.20％,83.90％and 74.20％,and the specificities were 78.90％,62.70％and 78.90％,respectively.The AUC of the combined detection of them three for diagnosing lung cancer was 0.932(95％CI:0.889-0.961,P＜0.001),the sensitivity was 80.60％,and the specificity was 93.00％.(4)The serum levels of CA125,CKAP4 and SCCA were higher in stage Ⅳ group[(60.32±11.84)u/mL,(639.56±123.94)ng/L,(8.17± 1.45)μg/L]than those in stage Ⅲ group[(45.68±9.74)u/mL,(549.22±116.47)ng/L,(6.35±1.22)μg/L]and stage Ⅰ-Ⅱ group[(39.12±7.40)u/mL,(420.56±94.25)ng/L,(5.51±1.01)μg/L](P＜0.05),and higher in stage Ⅲ group than those in stage Ⅰ-Ⅱ group(P＜0.05).Conclusion The levels of serum CA125,CKAP4 and SCCA significantly increase in patients with IPF complicated with lung cancer,the severity of IPF is correlated with the stage of lung cancer,and the combined detection of them three has a high value to the diagnosis of lung cancer in IPF patients.
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