Analysis Of Influential Factors Of Serum Tumor Markers In Patients With Nephrotic Syndrome

Objective:The experiments retrospectively analyzed changes in serum tumor markers commonly found in patients with nephrotic syndrome(NS)under different conditions,such as different levels of serum albumin,different levels of proteinuria,different levels of renal function,whether there were serious effusions,different pathological types,etc.,and further analyzed the factors that may affect the elevation of tumor markers,aimed at providing a basis for the diagnosis and treatment of patients with NS.Methods:A retrospective study was conducted to collect the clinical and pathological information of patients with NS who were hospitalized in the department of nephrology of China-Japan Union Hospital of Jilin University during 2014 to 2017,and had a variety of complete clinical testing data and clinical manifestations of renal biopsy.This study excluded patients with diseases that could cause edema,abnormal tumor markers and renal dysfunction.Healthy control group randomly selected from the Medical Center.All selected cases were performed blood test of tumor markers,routine blood biochemistry test,abdominal ultrasound or abdominal CT,chest ultrasound or chest X-ray or chest CT examination.Tumor markers(CA199,NSE,CEA,CA125,CYFRA211,AFP,SCC,CA242,CA153 and values of biochemistry test were compared between the nephrotic syndrome group(NS group)and the healthy control group,and according to serous effusion,renal function,menopause(female patients),albumin levels,urinary protein levels,pathological types,the levels of tumor markers in patients with NS were compared and analyzed,and further analysis of risk factors that could affect the elevation of tumor markers in the NS group were conducted.At the same time,a retrospective study was conducted to analyze pathological types and clinical characteristics of patients that diagnosed malignant tumor associated with NS in 2015 to 2017.SPSS17.0 software is used for data analysis.Result:1.The levels of CA199,NSE,CA125,CYFRA211,CA153,and CA242 in patients with NS were significantly higher than those in healthy controls(P<0.05).The changes of the levels of ALB,GLB,TG,TC,HDLC,LDLC,BUN CR,URIC,and Cys C were significantly different between the healthy control group and the NS group(P<0.05).2.The CA125 level in the NS group with effusion was significantly higher than that in the no effusion group(P<0.05).The differences in CA199,NSE,CYFRA211,AFP,CA153,SCC,and CA242 between the two groups were not significant(P>0.05).3.There was no statistical significance of tumor markers between normal renal function group and renal dysfunction group(P> 0.05).4.CA199 and CA242 were statistical significance between menopausal and non-menopausal(P <0.05),while NSE,CEA,CA125,CYFRA211,AFP,SCC and CA153 were no statistical significance(P > 0.05).5.CA125 was statistical significance between different albumin levels groups(P <0.01).CA199,CA242,NSE,CEA,CYFRA211,AFP,SCC and CA153 were no statistical significance between the three groups(P> 0.05).Comparing tumor markers between the two groups,CA125 in the albumin <15g/L group was significantly higher than albumin 15 ~ 20g/L group and albumin> 20g/L group(P < 0.01),AFP was no statistical significance between albumin group of 15 ~ 20 g / L and albumin> 20 g / L(P> 0.05).6.CA125 was statistical significance between different levels of proteinuria(P<0.05),CA199,CA242,NSE,CEA,CYFRA211,AFP,SCC and CA153 are no statistical significance between the three groups(P> 0.05).Comparing tumor markers between the two groups,CA125 of 24 hours urine protein> 10g/d group was significantly higher than 24 hours urinary protein <5g/d and 24 hours urinary protein 5 ~ 10g/d groups(P <0.05).Compared 24 hours urinary protein <5g / d group and 24 hours urinary protein 5 ~ 10 g / d,there was no statistical significance(P> 0.05).7.There were significant differences in the tumor markers among the different pathological types of SCC,and the differences were statistically significant.There were significant differences between other pathological types and membranous nephropathy group and minimal change group(P<0.05).CA199,CA242,NSE,CEA,CYFRA211,AFP,CA125,CA153 in all pathological types,the difference was not statistically significant(P> 0.05).8.After analyzing the risk factors that may affect the elevation of tumor markers,the results showed that e GFR rate was a risk factor for CA199 elevation(P<0.05),and ALB and age were risk factors for CA125 elevation(P<0.05).TG was a risk factor for increased NSE(P<0.05).Conclusion:1.The levels of CA199,NSE,CA125,CYFRA211,CA153 and CA242 in patients with nephrotic syndrome were elevated in different degrees.2.In this study,compared with other tumor markers,the elevation of CA125 in patients with nephrotic syndrome was the most significant,which was positively correlated with proteinuria,and negatively correlated with serum albumin.Adenocarcinoma is the most common pathological type in malignant tumor associated with nephrotic syndrome.3.The analysis of the risk factors for the elevation of tumor markers showed that estimated glomerular filtration rate was the independent risk factor for the elevation of serum level of CA199,serum albumin and age was the independent risk factor for the elevation of serum level of CA125.Triglyceride was the independent risk factor for the elevation of serum level of NSE.4.In this study,there was no significant correlation between the elevation of CYFRA211 level and the possible influencing factors,such as serum albumin,Triglyceride and age,at el.