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Tumor markers are associated with rapidly progressive interstitial lung disease in adult-dermatomyositis

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Abstract

Objectives

DM–associated rapidly progressive interstitial lung disease (DM-RP-ILD) has been the clinical conundrum. We assess the serum levels of tumor markers (TMs) in different types of ILD, and explore the diagnostic utility of TMs for DM/ADM-RP-ILD.

Methods

This was a retrospective cohort study, data including clinical and laboratory records were collected from the first affiliated hospital of Zhengzhou University from December 2015, to June 2020. Tumor markers (TMs) include CEA, CA153, CA724, CA125, and CA199. Spearman analysis, ROC, and Kaplan–Meier curve were used for data analysis.

Results

Total 272 patients (149 DM and 123 ADM) were enrolled, 152 (55.88%) with ILD (116 with chronic ILD, 36 with RP-ILD) and 120 (44.12%) without ILD among them. The serum levels of CEA and ferritin were significantly higher in patients with RP-ILD than in the other two groups. Serum CA125, CA199, and CA153 levels in patients with RP-ILD were higher than those without ILD. CEA levels were associated with the ferritin, KL-6 and anti-MDA5 levels, and CEA concentration was significantly negatively correlated with DLco (P = 0.016, R2 =  − 0.281). CEA [AUC = 0.7, 95% CI = (0.594, 0.806)] and ferritin [AUC = 0.737, 95% CI = (0.614, 0.860)] had diagnosed value for patients developing RP-ILD. Patients with high serum CEA levels had higher mortality rate within the DM-ILD population.

Conclusions

TMs and ferritin were increased in DM/ADM-RP-ILD, and serum CEA and CA153 levels can evaluate disease severity of DM. And CEA and ferritin can be used as noninvasive diagnostic biomarkers for patients with DM-RP-ILD.

Key Points

• Interstitial lung disease (ILD) is a serious complication of DM, and is a leading cause of mortality, especially rapidly progressive ILD.

• Tumor markers as a kind of noninvasive detection can reflect the disease severity of DM, and CEA and ferritin can be used to identify patients with RP-ILD.

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Funding

This study was supported by The Research Project of Medical Science and Technology of Henan Province of China (grant number LHGJ20190260), and The Key Specialized Research and Development Program of Henan (grant number 212102310754).

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Authors and Affiliations

  1. Department of Rheumatology, The First Affiliated Hospital of Zhengzhou University, Eastern Jianshe Road, Zhengzhou, 450052, Henan, China

    Qianqian Wang, Congcong Gao, Chunyi Zhang, Menghui Yao, Wenfang Liang, Wenbo Sun & Zhaohui Zheng

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  1. Qianqian Wang
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  2. Congcong Gao
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  4. Menghui Yao
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Correspondence to Zhaohui Zheng.

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This study was approved by the Human Ethics Board of the First Affiliated Hospital of Zhengzhou University (2020-KY-522). The study was performed in accordance with the Declaration of Helsinki and Good Clinical Practice guidelines.

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Wang, Q., Gao, C., Zhang, C. et al. Tumor markers are associated with rapidly progressive interstitial lung disease in adult-dermatomyositis. Clin Rheumatol 41, 1731–1739 (2022). https://doi.org/10.1007/s10067-022-06089-z

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