Elevated tumor markers in patients with pulmonary alveolar proteinosis
-
Shen-Cun Fang
Abstract
Background: The role of tumor markers in pulmonary alveolar proteinosis (PAP) remains unclear. This study investigated the tumor markers in serum and bronchoalveolar lavage fluid (BALF) in PAP patients and explored the relationship between tumor markers and the severity of PAP.
Methods: We retrospectively reviewed 38 patients with PAP.
Results: Mean serum carcinoembryonic antigen (CEA) and CYFRA21-1 levels were higher than the cut-off values (12.7±17.5 ng/mL and 10±10.66 ng/mL, respectively). Significant correlations were found between levels of CEA and neuron-specific enolase (NSE) in serum and serum lactate dehydrogenase (LDH) values (r=0.60, p<0.001 and r=0.56, p<0.001, respectively). A significant correlation was also observed between levels of squamous cell carcinoma (SCC) in serum and PaO2 and PA-aO2 (r=−0.49 p=0.01 and r=−0.51, p=0.01, respectively). The changes of CEA, SCC and NSE levels were consistent with the changes of LDH and PaO2. The serum levels of CEA, NSE and SCC were significantly lower after whole lung lavage compared with those before (8.7±10.6 vs. 15.7±22, 7.9±5.2 vs. 16.6±11.8, 0.4±0.24 vs. 0.59±0.42; p<0.05, respectively).
Conclusions: Elevated serum tumor marker levels were found in PAP patients. The serum levels of CEA, NSE and SCC may reflect the severity of the disease and predict the therapeutic effect of whole lung lavage.
Conflict of interest statement
Authors’ conflict of interest disclosure: The authors stated that there are no conflicts of interest regarding the publication of this article.
Research funding: None declared.
Employment or leadership: None declared.
Honorarium: None declared.
References
1. Khan A, Agarwal R. Pulmonary alveolar proteinosis. Respir Care 2011;56:1016–28.10.4187/respcare.01125Suche in Google Scholar PubMed
2. Martinez-Moczygemba M, Huston DP. Immune dysregulation in the pathogenesis of pulmonary alveolar proteinosis. Curr Allergy Asthma Rep 2010;10:320–5.10.1007/s11882-010-0134-ySuche in Google Scholar PubMed
3. Mukae H, Ishimoto H, Yanagi S, Ishii H, Nakayama S, Ashitani J, et al. Elevated BALF concentrations of alpha- and beta-defensins in patients with pulmonary alveolar proteinosis. Respir Med 2007;101:715–21.10.1016/j.rmed.2006.08.018Suche in Google Scholar PubMed
4. Lin FC, Chen YC, Chang SC. Clinical importance of bronchoalveolar lavage fluid and blood cytokines, surfactant protein D, and Kerbs von Lungren 6 antigen in idiopathic pulmonary alveolar proteinosis. Mayo Clin Proc 2008;83:1344–9.10.4065/83.12.1344Suche in Google Scholar
5. Hirakata Y, Kobayashi J, Sugama Y, Kitamura S. Elevation of tumor marker in serum and BALF in PAP. Eur Respir J 1995;8:689–96.10.1183/09031936.95.08050689Suche in Google Scholar
6. Sahin F, Yildiz P. Serum CA-125: biomarker of pulmonary tuberculosis activity and evaluation of response to treatment. Clin Invest Med 2012;35:223–8.10.25011/cim.v35i4.17151Suche in Google Scholar
7. Bulut I, Arbak P, Coskun A, Balbay O, Annakkaya AN, Yavuz O, et al. Comparison of serum CA 19.9, CA 125 and CEA levels with severity of chronic obstructive pulmonary disease. Med Princ Pract 2009;18:289–93.10.1159/000215726Suche in Google Scholar PubMed
8. Minakata Y, Kida Y, Nakanishi H, Nishimoto T, Yukawa S. Change in cytokeratin 19 fragment level according to the severity of pulmonary alveolar proteinosis. Intern Med 2001;40:1024–7.10.2169/internalmedicine.40.1024Suche in Google Scholar PubMed
9. Michaud G, Reddy C, Ernst A. Whole-lung lavage for pulmonary alveolar proteinosis. Chest 2009;136:1678–81.10.1378/chest.09-2295Suche in Google Scholar PubMed
10. Luisetti M, Kadija Z, Mariani F, Rodi G, Campo I, Trapnell BC. Therapy options in pulmonary alveolar proteinosis. Ther Adv Respir Dis 2010;4:239–48.10.1177/1753465810378023Suche in Google Scholar PubMed
11. Fang CS, Wang YC, Zhang TH, Wu J, Wang W, Wang C, et al. Clinical significance of serum lipids in idiopathic pulmonary alveolar proteinosis. Lipids Health Dis 2012;11:1–7.10.1186/1476-511X-11-12Suche in Google Scholar PubMed PubMed Central
12. Seymour JF, Presneill JJ. Pulmonary alveolar proteinosis progress in the first 44 years. Am J Respir Crit Care Med 2002;166:215–35.10.1164/rccm.2109105Suche in Google Scholar
13. Fujishima T, Honda Y, Shijubo N, Takahashi H, Abe S. Increased carcinoembryonic antigen concentrations in sera and bronchoalveolar lavage fluids of patients with pulmonary alveolar proteinosis. Respiration 1995;62:317–21.10.1159/000196473Suche in Google Scholar
14. Matsuoka Y, Endo K, Kawamura Y, Yoshida T, Saga T, Watanabe Y, et al. Normal bronchial mucus contains high levels of cancer-associated antigens, CA125, CA19-9, and carcinoembryonic antigen. Cancer 1990;65:506–10.10.1002/1097-0142(19900201)65:3<506::AID-CNCR2820650322>3.0.CO;2-0Suche in Google Scholar
15. Wang E, Lin D, Wang Y, Wu G, Yuan X. Immunohistochemical and ultrastructural markers suggest different origins for cuboidal and polygonal cells in pulmonary sclerosing hemangioma. Hum Pathol 2004;35:503–8.10.1016/j.humpath.2003.10.015Suche in Google Scholar
16. Nakamura Y, Nakamura H, Matsuse A, Monden J, Shimoda T, Kawano S, et al. Interesting case of pulmonary alveolar proteinosis. Nihon Naika Gakkai Zasshi 1995;84:1909–11.10.2169/naika.84.1909Suche in Google Scholar
©2013 by Walter de Gruyter Berlin Boston
Artikel in diesem Heft
- Masthead
- Masthead
- Editorials
- Biomarkers in the treatment of cancer: opportunities and pitfalls
- Multicenter reference intervals studies: a promising perspective for the future?
- Hemolysis-resistant reagent: another part of the puzzle for preventing errors in laboratory testing
- Review
- Exhaled breath condensate: a comprehensive update
- Mini Review
- Psoriasis, a new challenge for laboratory medicine
- Opinion Paper
- CA 19-9: handle with care
- General Clinical Chemistry and Laboratory Medicine
- Performance evaluation of human cytokines profiles obtained by various multiplexed-based technologies underlines a need for standardization
- The iron regulatory hormone hepcidin is decreased in pregnancy: a prospective longitudinal study
- Red blood cell distribution width is a potential prognostic index for liver disease
- Development of a novel, hemolysis-resistant reagent for assessment of α-amylase in biological fluids
- Performance of cassette-based blood gas analyzers to monitor blood glucose and lactate levels in a surgical intensive care setting
- Reference Values and Biological Variations
- The Asian project for collaborative derivation of reference intervals: (1) strategy and major results of standardized analytes
- The Asian project for collaborative derivation of reference intervals: (2) results of non-standardized analytes and transference of reference intervals to the participating laboratories on the basis of cross-comparison of test results
- Cancer Diagnostics
- Study of an elevated carbohydrate antigen 19-9 concentration in a large health check-up cohort in China
- Glycoproteomic identification of potential glycoprotein biomarkers in ovarian cancer proximal fluids
- Comparison of serum calcitonin and procalcitonin in detecting medullary thyroid carcinoma among patients with thyroid nodules
- Serum HER-2 predicts response and resistance to trastuzumab treatment in breast cancer
- Elevated tumor markers in patients with pulmonary alveolar proteinosis
- Serum carcinoembryonic antigen is associated with non-alcoholic fatty liver disease in healthy Korean non-smokers
- Assessment of SOX17 DNA methylation in cell free DNA from patients with operable gastric cancer. Association with prognostic variables and survival
- Sensitivity of CA 15-3, CEA and serum HER2 in the early detection of recurrence of breast cancer
- Cardiovascular Diseases
- Association of nucleotide-binding oligomerization domain-like receptor 3 inflammasome and adverse clinical outcomes in patients with idiopathic dilated cardiomyopathy
- Diabetes
- α1-Microglobulin/albumin ratio may improve interpretation of albuminuria in statin-treated patients
- Infectious Diseases
- The role of procalcitonin and IL-6 in discriminating between septic and non-septic causes of ALI/ARDS: a prospective observational study
- Letters to the Editor
- Carryover does not affect results of Beckman Coulter highly-sensitive-AccuTnI assay on Access 2
- Adding calcium to EDTA plasma samples prior to analysis could solve the compatibility issue in commercially available ELISAs that are standardized for serum
- Interference of luteinizing hormone in the urinary point-of-care human chorionic gonadotropin test
- Standardize the serum albumin assay now: calibrate it to 60% of the serum total protein assay
- Interference of M-paraprotein in automated urea assays
- A case of mistaken diagnosis of heparin-induced thrombocytopenia due to pseudothrombocytopenia
- Delta check: a must in the management of hyponatremia
- A novel cost effective algorithm for antinuclear antibody (ANA) testing in an outpatient setting
Artikel in diesem Heft
- Masthead
- Masthead
- Editorials
- Biomarkers in the treatment of cancer: opportunities and pitfalls
- Multicenter reference intervals studies: a promising perspective for the future?
- Hemolysis-resistant reagent: another part of the puzzle for preventing errors in laboratory testing
- Review
- Exhaled breath condensate: a comprehensive update
- Mini Review
- Psoriasis, a new challenge for laboratory medicine
- Opinion Paper
- CA 19-9: handle with care
- General Clinical Chemistry and Laboratory Medicine
- Performance evaluation of human cytokines profiles obtained by various multiplexed-based technologies underlines a need for standardization
- The iron regulatory hormone hepcidin is decreased in pregnancy: a prospective longitudinal study
- Red blood cell distribution width is a potential prognostic index for liver disease
- Development of a novel, hemolysis-resistant reagent for assessment of α-amylase in biological fluids
- Performance of cassette-based blood gas analyzers to monitor blood glucose and lactate levels in a surgical intensive care setting
- Reference Values and Biological Variations
- The Asian project for collaborative derivation of reference intervals: (1) strategy and major results of standardized analytes
- The Asian project for collaborative derivation of reference intervals: (2) results of non-standardized analytes and transference of reference intervals to the participating laboratories on the basis of cross-comparison of test results
- Cancer Diagnostics
- Study of an elevated carbohydrate antigen 19-9 concentration in a large health check-up cohort in China
- Glycoproteomic identification of potential glycoprotein biomarkers in ovarian cancer proximal fluids
- Comparison of serum calcitonin and procalcitonin in detecting medullary thyroid carcinoma among patients with thyroid nodules
- Serum HER-2 predicts response and resistance to trastuzumab treatment in breast cancer
- Elevated tumor markers in patients with pulmonary alveolar proteinosis
- Serum carcinoembryonic antigen is associated with non-alcoholic fatty liver disease in healthy Korean non-smokers
- Assessment of SOX17 DNA methylation in cell free DNA from patients with operable gastric cancer. Association with prognostic variables and survival
- Sensitivity of CA 15-3, CEA and serum HER2 in the early detection of recurrence of breast cancer
- Cardiovascular Diseases
- Association of nucleotide-binding oligomerization domain-like receptor 3 inflammasome and adverse clinical outcomes in patients with idiopathic dilated cardiomyopathy
- Diabetes
- α1-Microglobulin/albumin ratio may improve interpretation of albuminuria in statin-treated patients
- Infectious Diseases
- The role of procalcitonin and IL-6 in discriminating between septic and non-septic causes of ALI/ARDS: a prospective observational study
- Letters to the Editor
- Carryover does not affect results of Beckman Coulter highly-sensitive-AccuTnI assay on Access 2
- Adding calcium to EDTA plasma samples prior to analysis could solve the compatibility issue in commercially available ELISAs that are standardized for serum
- Interference of luteinizing hormone in the urinary point-of-care human chorionic gonadotropin test
- Standardize the serum albumin assay now: calibrate it to 60% of the serum total protein assay
- Interference of M-paraprotein in automated urea assays
- A case of mistaken diagnosis of heparin-induced thrombocytopenia due to pseudothrombocytopenia
- Delta check: a must in the management of hyponatremia
- A novel cost effective algorithm for antinuclear antibody (ANA) testing in an outpatient setting
