2025 年第 6 期 第 20 卷

肿瘤相关抗原在抗黑色素瘤分化相关基因5抗体阳性皮肌炎合并快速进展型间质性肺疾病中的临床意义

Clinical significance of tumor-associated antigen in anti-melanoma differentiation-associated gene 5 antibody positive dermatomyositis complicated with rapidly progressive interstitial lung disease

作者：鲁雪霞1王志霞1董菁菁1徐雪莲2李玉婷2李运霞1张志强1

英文作者：Lu Xuexia1 Wang Zhixia1 Dong Jingjing1 Xu Xuelian2 Li Yuting2 Li Yunxia1 Zhang Zhiqiang1

单位：1新乡医学院第一附属医院呼吸与危重症医学科，新乡453000;2新乡医学院第一附属医院放射治疗科，新乡453000

英文单位：1Department of Respiratory and Critical Care Medicine the First Affiliated Hospital of Xinxiang Medical University Xinxiang 453000 China; 2Department of Radiotherapy the First Affiliated Hospital of Xinxiang Medical University Xinxiang 453000 China

关键词：皮肌炎；抗黑色素瘤分化相关基因5；快速进展型间质性肺疾病；癌胚抗原；细胞角蛋白19血清片段21-1

英文关键词：Dermatomyositis;Anti-melanomadifferentiation-associatedgene5;Rapidlyprogressinginterstitiallungdisease;Carcinoembryonicantigen;Cytokeratin19serumfragment21-1

• 摘要：

• 目的 分析肿瘤相关抗原对抗黑色素瘤分化相关基因5（MDA5）抗体阳性皮肌炎患者发生快速进展型间质性肺疾病（RP-ILD）的影响。方法 回顾性选取2018年8月至2023年7月于新乡医学院第一附属医院明确诊断的抗MDA5抗体阳性皮肌炎患者36例，根据是否发生RP-ILD将患者分为RP-ILD组（13例）和非RP-ILD组（23例）。收集患者临床资料，采用Logistic回归分析评估抗MDA5阳性皮肌炎患者发生RP-ILD的潜在风险因素。结果 RP-ILD组细胞角蛋白19血清片段21-1（CYFRA21-1）、癌胚抗原水平均高于非RP-ILD组（均P＜0.05）。CYFRA21-1和癌胚抗原分别联合性别、抗Ro-52抗体、铁蛋白进行多因素Logistic回归模型分析，发现CYFRA21-1（比值比=1.137,95%置信区间：1.028~1.258）、癌胚抗原（比值比=1.348,95%置信区间：1.057~1.718）为发生RP-ILD的危险因素（均P＜0.05）。结论 血清CYFRA21-1、癌胚抗原表达升高与抗MDA5抗体阳性皮肌炎患者发生RP-ILD的风险相关。

• Objective To analyze the effect of tumor-associated antigens on the development of rapidly progressive interstitial lung disease (RP-ILD) in patients with anti-melanoma differentiation-associated gene 5 (MDA5) antibody positive dermatomyositis. Methods Thirty-six patients with anti-MDA5 antibody positive dermatomyositis diagnosed in the First Affiliated Hospital of Xinxiang Medical University from August 2018 to July 2023 were retrospectively selected. The patients were divided into RP-ILD group (13 cases) and non-RP-ILD group (23 cases) according to whether RP-ILD occurred. The clinical data of the patients were collected, and Logistic regression analysis was used to evaluate the potential risk factors for RP-ILD in anti-MDA5 positive dermatomyositis patients. Results The levels of cytokeratin 19 serum fragment 21-1 (CYFRA21-1) and carcinoembryonic antigen in the RP-ILD group were higher than those in the non-RP-ILD group (both P<0.05). Multivariate Logistic regression model analysis was performed on CYFRA21-1 and carcinoembryonic antigen combined with gender, anti-Ro-52 antibody and ferritin, respectively, and it was found that CYFRA21-1 ［odds ratio=1.137, 95% confidence interval (CI): 1.028-1.258］ and carcinoembryonic antigen (odds ratio=1.348, 95%CI: 1.057-1.718) were risk factors for the development of RP-ILD (both P<0.05). Conclusions Elevated serum levels of CYFRA21-1 and CEA expression are associated with the risk of RP-ILD in anti-MDA5 antibody positive dermatomyositis patients.