上海交通大学学报(医学版)

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老年2型糖尿病患者5种血清肿瘤标志物的表达及影响因素分析

徐媛媛1,赵洪2,张宇2,孙皎1,顾芹1,汪海东1,朱君秋2   

  1. 复旦大学附属华东医院 1.内分泌科, 2.肿瘤科, 上海 200040
  • 出版日期:2016-07-28 发布日期:2016-08-31
  • 通讯作者: 朱君秋, 电子信箱: autumnauther@163.com。
  • 作者简介:徐媛媛(1986—), 女, 主治医师, 硕士; 电子信箱: yaya19860223@126.com。

Analysis of levels of five serum tumor markers and related influencing factors for elderly patients with type 2 diabetes

XU Yuan-yuan1, ZHAO Hong2, ZHANG Yu2, SUN Jiao1, GU Qin1, WANG Hai-dong1, ZHU Jun-qiu2   

  1. 1.Department of Endocrinology, 2.Department of Oncology, Huadong Hospital, Fudan University, Shanghai 200040, China
  • Online:2016-07-28 Published:2016-08-31

摘要:

目的 分析老年2型糖尿病患者血清肿瘤标志物CA199、CEA、CA153、CA125、AFP的水平及其影响因素。方法 收集2012年6月—2014年7月收治的老年2型糖尿病患者[糖尿病组,平均年龄(61.53±4.95)岁,n=241]的资料,以年龄匹配的同时期接受健康体检者的资料作为对照(对照组,n=178)。比较2组5种血清肿瘤标志物水平。根据糖化血红蛋白水平和年龄将糖尿病组患者进行再分组,比较各组患者血清肿瘤标志物水平;利用Pearson相关分析和多因素Logistic回归分析相关影响因素。结果 糖尿病组患者血清CA199、CEA、CA153水平明显高于对照组(P<0.05)。不同糖化血红蛋白水平组的血清CA199、CEA表达水平的差异有统计学意义(P<0.05);不同年龄组的血清CA199、CEA和CA153水平的差异有统计学意义(P<0.05)。Logistic回归分析结果显示:BMI升高、血白蛋白水平降低是血清CA199水平升高的危险因素;年龄增大是血清CEA 、CA153水平升高的危险因素;血肌酐水平升高、血白蛋白水平下降是血清CA125水平升高的危险因素。结论 老年2型糖尿病患者部分血清肿瘤标志物水平升高,临床判读时应结合其糖化血红蛋白水平、年龄等因素综合考虑,长期随访,以免误诊和漏诊。

关键词: 肿瘤标志物, 2型糖尿病, 老年

Abstract:

Objective To analyze the levels of serum tumor markers CA199, CEA, CA153, CA125, and AFP in elderly patients with type 2 diabetes and related influencing factors. Methods Data of elderly patients with type 2 diabetes (the diabetes group with average age of 61.53±4.95, n=241) admitted between June 2012 and July 2014 were collected. The age-matched healthy individuals receiving physical examination at the same time period served as controls (the control group, n=178). The levels of five serum tumor markers were compared between two groups. The diabetes group was regrouped according to HbA1C level and age and the levels of serum tumor markers were compared between subgroups. Pearson correlation analysis and multi-factor Logistic regression analysis were used to analyze related influencing factors. Results The levels of serum CA199, CEA, and CA153 were significantly higher in the diabetes group than in the control group (P<0.05). The differences in serum CA199 and CEA levels in subgroups with different HbA1C levels were statistically significant (P<0.05) and the differences in serum CA199, CEA, and CA153 levels in subgroups with different ages were statistically significant (P<0.05). Logistic regression analysis showed that increased BMI and decreased serum albumin were risk factors for elevated serum CA199 level and increased age was a risk factor for elevated serum CEA and CA153 levels, while increased serum creatinine level and decreased serum albumin level were risk factors for elevated CA125 level. Conclusion Levels of some serum tumor markers increase in elderly patients with type 2 diabetes. HbA1C level and age should be taken into account for clinical interpretation. Long term follow-up is needed to avoid misdiagnoses and missed diagnoses.

Key words: tumor marker, type 2 diabetes, elderly