The relationship between serum tumor markers and the severity of silicosis

Abstract

Objective To investigate the relationship between serum tumor markers and the severity of silicosis. Methods Retrospective study.Total of 160 patients with silicosis were included in the study, and 160 healthy volunteers were recruited as the control group. Tumor marker levels in both bronchoalveolar lavage fluid(BALF)and serum were detected by the immunochemiluminecence methods. The pulmonary function parameters, blood gas analysis and lactate dehydrogenase(LDH)were also analyzed. Lung tissue obtained by a patient with silicosis was stained by neuron specific enolase(NSE), carbohydrate antigen125(CA125) and carbohydrate antigen19-9(CA19-9). Results Serum NSE, CA125 and CA19-9 levels were significantly higher in cases than those in controls[(34.47±13.30)μg/L vs(10.24±7.20)μg/L, t=20.27, P<0.000 1; (33.96±17.80)kU/L vs(12.23±15.30)kU/L, t=11.71, P<0.000 1; (4.68±5.67)kU/L vs(2.78±3.45)kU/L, t=3.67, P<0.002]. Significant negative correlations were found between values of tumor markers(CA125 and CA19-9) and spirometric parameters, such as forced expiratory volume in one second %(FVE1%), forced expiratory volume in one second/forced vital capacity(FVE1/FVC), carbon monoxide diffusion capacity (Dlco) and total lung capacity(TLC) (r=-0.423, P=0.001; r=-0.323, P=0.011; r=-0.479, P=0.001; r=-0.285, P=0.043) and (r=-0.324, P=0.022; r=-0.256, P=0.023; r=-0.354, P=0.013; r=-0.356, P=0.012). Significant positive correlations were also observed between values of these tumor markers and LDH(r=0.378, P=0.001 and r=0.347, P=0.21). Significant negative correlations were found between NSE and Dlco and TLC(r=-0.374, P=0.004 and r=-0.368, P=0.002). Significant positive correlations were also observed between NSE and LDH(r=0.404, P=0.001). The NSE and CA19-9 levels in BALF were significantly higher than those in serum[(39.32±29.30)μg/L vs(25.7±12.12)μg/L, t=2.15, P=0.036; (21.36±12.11)kU/L vs(11.28±10.78)kU/L, t=2.64, P=0.012]. Patients experienced a decrease in NSE and CA19-9 concentrations following whole lung lavage[(39.20±10.24)μg/L vs(15.32±8.35)μg/L, t=8.02, P<0.05; (26.24±12.23)kU/L vs(18.84±5.64)kU/L, t=2.46, P<0.05]. Immunohistochemical studies showed positive NSE and CA19-9 staining in lung biopsy specimen. Conclusion Elevated serum tumor markers including NSE, CA125 and CA19-9 would provide valuable clinical information to assess disease severity in silicosis.(Chin J Lab Med, 2017, 40: 515-519) Key words: Silicosis; Tumor markers, biological; CA-125 antigen; CA-19-9 antigen