| Objective: To investigate the correlation between the levels of tumor markers CA72-4 and pepsinogen(PG)and colchicine treatment in gout patients,and to observe the effects of different doses of colchicine on the level of CA72-4 in gout treatment,and further explore the cause of CA72-4 rise after colchicine treatment.Methods: 192 cases of gout patients from January 2016 to July 2017 in the Department of Endocrinology and Rheumatology of the First Affiliated Hospital of Shihezi University Medical College,according to within two weeks before the visit without oral colchicine,the gout patients were divided into medication group(n=90)and non-medication group(n=102).The general data(gender,age,duration of illness)of all patients were collected.And the uric acid(UA),C-reactive protein(CRP),procalcitonin(PCT),erythrocyte sedimentation rate(ESR),and the levels of tumor markers CA72-4,AFP,CEA,CA153,CA199,CYFRA21-1and pepsinogen PGI,PGII,PGI/II at the time of the initial diagnosis were detected in both groups of patients.The general data and serological data of the medication group and the non-medication group were compared,and the correlation between the CA72-4 level of the medication group and the serological indicators at the initial diagnosis was analyzed.The serological indicators of colchicine treatment were administered to the medication group for 2weeks.The patients were tested for serological indicators 2 weeks after the withdrawal.The differences in the indicators and the trend of changes were compared.The ROC curve was used to evaluate the diagnostic efficacy of CA72-4 and PGI in patients with gout after taking colchicine.According to the dose of colchicine,the medication group was divided into group A: oral colchicine 0.5 mg/time,3 times/day(n=18);group B: oral colchicine 1 mg/time,3times/ Day(n=45);group C: Colchicine 1 mg/time,1 time/2h,6 times/day(n=27),compare the difference in CA72-4 levels between the three groups after 2 weeks of medication and three groups Changes in CA72-4 levels before and after treatment were stopped.Results:(1)At the initial diagnosis,the levels of CA72-4 and pepsinogen PGI in the medication group and the non-medication group were significantly different(P<0.05).There was no significant difference in gender,age,duration of disease,AFP,CEA,CA153,CA199,CYFRA21-1,PGII,and PGI/II between the two groups(P>0.05).(2)The correlation analysis between CA72-4 and UA,CRP,PCT,ESR,PGI,PGII,and PGI/II of the medication group showed that there was a positive correlation between CA72-4 and PGI,and the correlation coefficient was 0.598,P<0.05.(3)There were differences between the three subgroups of UA,ESR,CRP,and PCT in the medication group,and their levels decreased significantly with the reduction of gout symptoms(P<0.05).After 2 weeks of treatment,the levels of CA72-4 and PGI were significantly higher(P<0.05).After 2 weeks of drug withdrawal,the CA72-4 level of the medication group decreased significantly and basically returned to normal values(P<0.05).PGI levels decreased,but the decrease was not significantly different from that at 2weeks of treatment(P>0.05);AFP,CEA,CA153,CA199,CYFRA21-1,PGII,and PGI/II levels did not have significant difference in the three subgroups(P>0.05).(4)The area under the ROC curve of CA72-4 and PGI were 0.906 and 0.777 respectively,and the AUC of CA72-4 level was greater than PGI;(5)After taking the medication group,the level of CA72-4 rose with the increase of colchicine dose.There was a statistically significant difference in the high trend(P>0.05).Therefore,comparisons were made between the three groups in the two-week treatment group.The differences between group A and group B were statistically significant(P<0.05).The differences between group A and group C were statistically significant(P<0.05).The change of CA72-4 in group A was not significant(P>0.05),and the change of CA72-4 was significant in group B after 2 weeks of discontinuation(P<0.05).The change of CA72-4 was significant(P<0.05)after 2 weeks withdrawal in group C.In group A,group B and group C,the levels of CA72-4 all returned to normal after 2 weeks of discontinuation.The difference was not statistically significant(P>0.05).Conclusion: There may be a correlation between elevated levels of CA72-4 and PGI in patients with gout and taking colchicine.The level of CA72-4 has good reference value in the change of gout patient’s condition.The effect on CA72-4 basically disappeared after stopping taking colchicine.The change of CA72-4 may have a certain correlation with the dose of the drug,and the influencing factors may be related to the adverse reaction of colchicine.Therefore,the occurrence of this phenomenon should not be ignored in clinical treatment.The level of CA72-4 should be reexamined after the patient has stopped taking colchicine,and the effect of the drug on the tumor detection index should be eliminated. |
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