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Computed tomography of pulmonary changes in rheumatoid arthritis: carcinoembryonic antigen (CEA) as a marker of airway disease

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Abstract

Rheumatoid arthritis (RA) classically affects the joints, but can present extra-articular manifestations, including pulmonary disease. The present study aimed to identify possible risk factors or laboratory markers for lung involvement in RA, particularly the presence of rheumatoid factor (RF), anti-citrullinated peptide antibodies (ACPA), and tumor markers, by correlating them with changes observed on chest high-resolution computerized tomography (HRCT). This cross-sectional study involved RA patients who were examined and questioned by a specialist physician and later subjected to chest HRCT and blood collection for measurement of C-reactive protein (CRP), erythrocyte sedimentation rate (ESR), rheumatoid factor (RF), ACPA (anti-vimentin and/or anti-CCP3), and the tumor markers carcinoembryonic antigen (CEA), CA 125, CA 15-3, and CA 19-9. A total of 96 patients underwent chest HRCT. The most frequent findings were bronchial thickening (27/28.1 %) and bronchiectasis (25/26 %). RF was present in 63.2 % of patients (55/87), and ACPA (anti-vimentin or anti-CCP3) was present in 72.7 % of patients (64/88). CEA levels were high in 14 non-smokers (37.8 %) and 23 smokers (62.2 %). CA-19-9 levels were high in 6 of 86 patients (7.0 %), CA 15-3 levels were high in 3 of 85 patients (3.5 %), and CA 125 levels were high in 4 of 75 patients (5.3 %). Multivariate analysis indicated a statistically significant association between high CEA levels and the presence of airway changes in patients with RA (p = 0.048). CEA can serve as a predictor of lung disease in RA and can help identify individuals who require more detailed examination for the presence of respiratory disorders.

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Acknowledgments

This study was funded by resources of Hospital Universitario Polydoro Ernani de São Thiago (HU-UFSC).

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Authors and Affiliations

  1. Radiology Unit, Hospital Universitario Polydoro Ernani de São Thiago, Universidade Federal de Santa Catarina (HU-UFSC), Florianópolis, Brazil

    Milene Caroline Koch

  2. Rheumatology Unit, HU-UFSC, Florianópolis, Brazil

    Ivânio Alves Pereira

  3. Internal Medicine Department, UFSC, Florianópolis, Brazil

    Luiz Felipe Souza Nobre & Fabricio Souza Neves

  4. Departamento de Clínica Médica, Hospital Universitário, Universidade Federal de Santa Catarina, 3 Andar, Trindade, Florianópolis, SC, 88040-900, Brazil

    Fabricio Souza Neves

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  1. Milene Caroline Koch
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Correspondence to Fabricio Souza Neves.

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Authors Koch MC, Pereira IA, Nobre LFS, and Neves FS declare that they have no conflict of interest.

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All procedures performed in this study were in accordance with the ethical standards of the institutional research committee (approved under protocol no. 118.891) and with the 1964 Helsinki Declaration and its later amendments. Informed consent was obtained from all individual participants included in the study.

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Koch, M.C., Pereira, I.A., Nobre, L.F.S. et al. Computed tomography of pulmonary changes in rheumatoid arthritis: carcinoembryonic antigen (CEA) as a marker of airway disease. Rheumatol Int 36, 531–539 (2016). https://doi.org/10.1007/s00296-016-3438-y

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