The Study Of CA-153 In The Course Of Megaloblastic Anemia And Myelodysplastic Syndrome Abstract

BackgroundIn the investigation of MA patients,we found that the serum tumor marker was abnormally increased in these patients.After appropriate treatment,the tumor marker gradually decreased to normal.At present,there is lack of specific expression and clinical significance of serum CA-153 in the course of MA patients.In china,the primary medical institutions are limited by the technical and equipment condition,which causes the differential diagnosis between MA and MDS difficultly.PurposeThis study through the comparison of serum CA-153 between MA group and normal control group,explore the expression of CA-153 in MA patients and its correlation with other clinical indexes,then investigate the significance of the serum tumor markers in the process of MA disease.Further more,compare the levels of CA-153 and other serum tests in the two groups of patients with MA and MDS,investigate the value of CA-153 combine with serum FA,VitB12,TBIL,IBIL and LDH in different diagnosis of MA and MDS.methods1.Data collectionMA research group:collect total 48 cases as samples from the hematology specialty in the First Affiliated Hospital of Henan University Department and the hematology specialty in the Lankao County Central Hospital Department.patients were divided into the study group（30 male and 18 female）,median age 56 years（37-78 years）.Normal control group:42 cases without related diseases were from the physical examination center,of which the age and sex matched with the MA group.There were 25 males and 17 females,with a median age of 52 years（39-71 years）.Those who had anemia disease,malignant tumor,benign and malignant hyperplasia of mammary glands were excluded.MDS control group:40 patients with a diagnosis of MDS have been collected from the First Affiliated Hospital of Henan University Department of hematology and the Lankao County Central Hospital Department of hematology,which have complete data and were divided into the MDS control group（21 male and 19 female）,median age 64 years（52-79 years）.2.Research methodologyRoutine,biochemical and immunological tests were completed in each group,and bone marrow related examinations were performed in the MA and MDS groups.Then the MA study group was supplemented with FA and VitB12 treatments.Blood routine was determined by automatic blood routine classification instrument.Blood biochemistry was determined by automatic biochemistry analyzer,Serum tumor markers CA-153,FA,VitB12 and SF were detected by chemiluminescence microparticle immunoassay.Statistical processingThe application statistics software SPSS 17 was used as the test kit.p<0.05 was statistically significant.Result1.The serum CA-153 levels in MA patients of the study group before treatment were significantly higher than the normal control group（51.10±5.77 U/ml vs 18.77±5.30 U/ml,p<0.01）,the difference was statistically significant.2.The patients from MA study group were supplemented with folic acid and vitamin B12,then the blood serum CA-153 levels returned to normal after routine blood routine returned to normal.The levels of serum CA-153 after treatment were lower than that before treatment（21.92±4.52 U/ml vs51.10±5.77 U/ml,p<0.001）,the difference was statistically significant.3.The serum CA-153 levels before treatment in MA group were negatively correlated with Hb （r=-0.882,p<0.001）,positive correlation with the serum level of lactate dehydrogenase（r=0.455,p=0.001）.Serum FA,VitB12,MCV,age,gender and other biochemical indexes had no obvious correlation.4.The average serum FA,VitB₁₂ and SF levels in the patients with MA were significantly lower than those in the MDS group,the difference was statistically significant.5.The average serum CA-153,LDH,TBIL,IBIL levels of the patients with MA were significantly higher than those in the MDS group,the difference was statistically significant.Conclusion1.The serum CA-153 levels were elevated in patients with MA before treatment,and after supplementation with FA and VitB12 treatment,the serum tumor markers decreased to normal when blood routine returned to normal.The serum CA-153 levels in patients with MA before treatment were negatively correlated with Hb concentration and positively correlated with LDH levels.Serum CA-153 can be used as the basis for early diagnosis of MA.2.The detection of CA-153 combined with serum FA,VitB12,LDH is helpful to the differential diagnosis of MA and MDS,especially in the basic level hospitals without bone marrow biopsy and related gene testing,that has important clinical value.