Association of elevated serum carbohydrate antigen 19-9 levels with extensive interstitial lung disease in patients with systemic sclerosis: A cross-sectional study.

CA19-9 biomarker interstitial lung disease systemic sclerosis

Journal

International journal of rheumatic diseases
ISSN: 1756-185X
Titre abrégé: Int J Rheum Dis
Pays: England
ID NLM: 101474930

Informations de publication

Date de publication:
20 Nov 2023
Historique:
revised: 30 08 2023
received: 02 05 2023
accepted: 08 11 2023
medline: 20 11 2023
pubmed: 20 11 2023
entrez: 20 11 2023
Statut: aheadofprint

Résumé

To assess the usefulness of carbohydrate antigen 19-9 (CA19-9) as a biomarker for systemic sclerosis-associated interstitial lung disease (SSc-ILD), using serum samples and clinical parameters of patients with SSc. Patients with SSc admitted to Tokyo Women's Medical University Hospital between 2010 and 2021 and those who underwent chest computed tomography (CT) were included. Patients were diagnosed with ILD based on chest CT findings, and SSc-ILD was categorized as either a limited or extensive disease based on chest CT and pulmonary function test findings. Serum CA19-9 levels were measured in 56 patients with SSc and in 32 healthy individuals. Additionally, we evaluated the difference in serum CA19-9 levels between the groups, the correlation with ILD area and pulmonary function, and discriminative performance to diagnose extensive ILD. Of the 56 patients with SSc, 40 (71.4%) had ILD, and 17 (30.4%) were classified as having extensive disease. Serum CA19-9 levels were significantly elevated in patients with extensive disease compared to those with limited disease (median [interquartile range]: 25.7 U/mL [10.1-50.8] vs. 8.8 U/mL [4.5-17.6], p = .02) and correlated with ILD area (r = .30, p = .02). There was no significant correlation between serum CA19-9 level and pulmonary function. The cutoff of CA19-9 for the diagnosis of the extensive disease was determined to be 19.8 U/mL, with a sensitivity of 64% and specificity of 82% and an area under the curve of 0.74 (95% confidence interval 0.58-0.90). The serum CA19-9 level may be a useful marker for identifying patients with SSc-ILD with extensive disease.

Identifiants

pubmed: 37983908
doi: 10.1111/1756-185X.14978
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Subventions

Organisme : Ministry of Health, Labour and Welfare

Informations de copyright

© 2023 Asia Pacific League of Associations for Rheumatology and John Wiley & Sons Australia, Ltd.

Références

Denton CP, Khanna D. Systemic sclerosis. Lancet. 2017;390(10103):1685-1699.
Tyndall AJ, Bannert B, Vonk M, et al. Causes and risk factors for death in systemic sclerosis: a study from the EULAR scleroderma trials and research (EUSTAR) database. Ann Rheum Dis. 2010;69(10):1809-1815.
Molberg Ø, Hoffmann-Vold AM. Interstitial lung disease in systemic sclerosis: progress in screening and early diagnosis. Curr Opin Rheumatol. 2016;28(6):613-618.
Hoffmann-Vold AM, Allanore Y, Alves M, et al. Progressive interstitial lung disease in patients with systemic sclerosis-associated interstitial lung disease in the EUSTAR database. Ann Rheum Dis. 2021;80(2):219-227.
Volkmann ER, Tashkin DP, Sim M, et al. Short-term progression of interstitial lung disease in systemic sclerosis predicts long-term survival in two independent clinical trial cohorts. Ann Rheum Dis. 2019;78(1):122-130.
Distler O, Assassi S, Cottin V, et al. Predictors of progression in systemic sclerosis patients with interstitial lung disease. Eur Respir J. 2020;55(5):1902026. doi:10.1183/13993003.02026-2019
Bonhomme O, André B, Gester F, et al. Biomarkers in systemic sclerosis-associated interstitial lung disease: review of the literature. Rheumatology (Oxford). 2019;58(9):1534-1546.
Distler O, Highland KB, Gahlemann M, et al. Nintedanib for systemic sclerosis-associated interstitial lung disease. N Engl J Med. 2019;380(26):2518-2528.
Elhai M, Hoffmann-Vold AM, Avouac J, et al. Performance of candidate serum biomarkers for systemic sclerosis-associated interstitial lung disease. Arthritis Rheumatol. 2019;71(6):972-982.
Sato S, Nagaoka T, Hasegawa M, Nishijima C, Takehara K. Elevated serum KL-6 levels in patients with systemic sclerosis: association with the severity of pulmonary fibrosis. Dermatology. 2000;200(3):196-201.
Hu Y, Wang LS, Jin YP, et al. Serum Krebs von den Lungen-6 level as a diagnostic biomarker for interstitial lung disease in Chinese patients. Clin Respir J. 2017;11(3):337-345.
Volkmann ER, Tashkin DP, Kuwana M, et al. Progression of interstitial lung disease in systemic sclerosis: the importance of pneumoproteins Krebs von den Lungen 6 and CCL18. Arthritis Rheumatol. 2019;71(12):2059-2067.
Shirai Y, Fukue R, Kaneko Y, Kuwana M. Clinical relevance of the serial measurement of Krebs von den Lungen-6 levels in patients with systemic sclerosis-associated interstitial lung disease. Diagnostics (Basel). 2021;11(11):2007. doi:10.3390/DIAGNOSTICS11112007
Hant FN, Ludwicka-Bradley A, Wang HJ, et al. Surfactant protein D and KL-6 as serum biomarkers of interstitial lung disease in patients with scleroderma. J Rheumatol. 2009;36(4):773-780.
Elhaj M, Charles J, Pedroza C, et al. Can serum surfactant protein D or CC-chemokine ligand 18 predict outcome of interstitial lung disease in patients with early systemic sclerosis? J Rheumatol. 2013;40(7):1114-1120.
Matsuoka Y, Endo K, Kawamura Y, et al. Normal bronchial mucus contains high levels of cancer-associated antigens, CA125, CA19-9, and carcinoembryonic antigen. Cancer. 1990;65(3):506-510.
Maher TM, Oballa E, Simpson JK, et al. An epithelial biomarker signature for idiopathic pulmonary fibrosis: an analysis from the multicentre PROFILE cohort study. Lancet Respir Med. 2017;5(12):946-955.
Jin Q, Zheng J, Xu X, et al. Value of serum carbohydrate antigen 19-9 and carcinoembryonic antigen in evaluating severity and prognosis of connective tissue disease-associated interstitial lung disease. Arch Rheumatol. 2018;33(2):190-197.
Mukae H, Hirota M, Kohno S, et al. Elevation of tumor-associated carbohydrate antigens in patients with diffuse panbronchiolitis. Am Rev Respir Dis. 1993;148(3):744-751.
Kodama T, Satoh H, Ishikawa H, Ohtsuka M. Serum levels of CA19-9 in patients with nonmalignant respiratory diseases. J Clin Lab Anal. 2007;21(2):103-106.
Bao Y, Zhang W, Shi D, Bai W, He D, Wang D. Correlation between serum tumor marker levels and connective tissue disease-related interstitial lung disease. Int J Gen Med. 2021;14:2553-2560.
Szekanecz E, Szucs G, Szekanecz Z, et al. Tumor-associated antigens in systemic sclerosis and systemic lupus erythematosus: associations with organ manifestations, immunolaboratory markers and disease activity indices. J Autoimmun. 2008;31(4):372-376.
van den Hoogen F, Khanna D, Fransen J, et al. 2013 classification criteria for systemic sclerosis: an American College of Rheumatology/European league against rheumatism collaborative initiative. Arthritis Rheum. 2013;65(11):2737-2747.
Murai J, Soga S, Saito H, et al. Study on the mechanism causing elevation of serum CA19-9 levels in diabetic patients. Endocr J. 2013;60(7):885-891.
Du ZX, Liang MM, Sun J, Wang WJ, Liu YH, Yang JH. Clinical significance of serum CA-125, CA19-9 and CEA in pulmonary tuberculosis with and without type 2 diabetes. Tuberculosis (Edinb). 2017;107:104-110.
Goh NS, Desai SR, Veeraraghavan S, et al. Interstitial lung disease in systemic sclerosis: a simple staging system. Am J Respir Crit Care Med. 2008;177(11):57-59.
Zheng M, Lou A, Zhang H, Zhu S, Yang M, Lai W. Serum KL-6, CA19-9, CA125 and CEA are diagnostic biomarkers for rheumatoid arthritis-associated interstitial lung disease in the Chinese population. Rheumatol Ther. 2021;8(1):517-527.
Fahim A, Crooks MG, Wilmot R, Campbell AP, Morice AH, Hart SP. Serum carcinoembryonic antigen correlates with severity of idiopathic pulmonary fibrosis. Respirology. 2012;17(8):1247-1252.
Biomarkers Definitions Working Group. Biomarkers and surrogate endpoints: preferred definitions and conceptual framework. Clin Pharmacol Ther. 2001;69(3):89-95.
Khanna D, Distler O, Cottin V, et al. Diagnosis and monitoring of systemic sclerosis-associated interstitial lung disease using high-resolution computed tomography. J Scleroderma Relat Disord. 2022;7(3):168-178.

Auteurs

Hikaru Hirose (H)

Division of Rheumatology, Department of Internal Medicine, Tokyo Women's Medical University School of Medicine, Tokyo, Japan.

Tomoaki Higuchi (T)

Division of Rheumatology, Department of Internal Medicine, Tokyo Women's Medical University School of Medicine, Tokyo, Japan.
Division of Multidisciplinary Management of Rheumatic Diseases, Tokyo Women's Medical University School of Medicine, Tokyo, Japan.

Kae Takagi (K)

Division of Rheumatology, Department of Internal Medicine, Tokyo Women's Medical University School of Medicine, Tokyo, Japan.
Department of Internal Medicine, Adachi Medical Center, Tokyo Women's Medical University School of Medicine, Tokyo, Japan.

Akiko Tochimoto (A)

Division of Rheumatology, Department of Internal Medicine, Tokyo Women's Medical University School of Medicine, Tokyo, Japan.

Yuki Ichimura (Y)

Division of Rheumatology, Department of Internal Medicine, Tokyo Women's Medical University School of Medicine, Tokyo, Japan.
Department of Dermatology, Graduate School of Medical and Dental Science, Tokyo Medical and Dental University, Tokyo, Japan.

Yasuhiro Katsumata (Y)

Division of Rheumatology, Department of Internal Medicine, Tokyo Women's Medical University School of Medicine, Tokyo, Japan.

Masayoshi Harigai (M)

Division of Rheumatology, Department of Internal Medicine, Tokyo Women's Medical University School of Medicine, Tokyo, Japan.

Yasushi Kawaguchi (Y)

Division of Rheumatology, Department of Internal Medicine, Tokyo Women's Medical University School of Medicine, Tokyo, Japan.

Classifications MeSH