Research Report, Summarized by Mary McNeil, SjSC
Approximately 25% of Sjögren’s patients will develop interstitial lung disease (ILD), however, early diagnosis of ILD is still a challenge. ILD is characterized by inflammation and irreversible scarring of the lungs, resulting in cough and shortness of breath that can seriously impact quality of life and even decrease survival. Early symptoms of ILD are unusual and sometimes asymptomatic in Sjögren’s patients leading to patients not being diagnosed or treated in the early stages.
The study, “Increases in tumor markers are associated with primary Sjögren’s-associated interstitial lung disease” was published in Therapeutic Advances in Chronic Diseases (2020, Vol.11: 1-9). Researchers at The Second Hospital of Shanxi Medical University in China stated that there is a need for accurate biomarkers to predict the likelihood of having ILD in Sjögren’s patients. The study was a retrospective analysis of 706 patients recruited by the hospital who have a confirmed diagnosis of primary Sjögren’s and then followed from January 2015 until April 2019.
All enrolled subjects underwent a biochemical assessment which included a complete blood count and tumor markers, as well as high-resolution CT scans to identify ILD clinical indicators such as reticular abnormalities, honeycombing, and traction bronchiectasis. Patients with malignant disease, significant infection, liver and kidney dysfunction or other rheumatic diseases were excluded. Of those 706 Sjögren’s patients, 168 (24%) were deemed to have ILD. Patients with and without ILD generally had similar demographic characteristics in terms of age, sex, and disease duration but those with ILD had greater disease activity, higher platelet counts and increased markers of inflammation.
Researchers found that blood levels of tumor markers NSE, CEA, CA125, and CA 153 were all significantly higher in Sjögren’s patients with ILD than those without ILD. Statistical analysis found that CA 153 had the highest diagnostic value over the other biomarkers, being able to distinguish ILD from non-ILD patients with an accuracy of 74%. A combination of all four biomarkers raised the accuracy to 77%. The study’s limitations included the retrospective nature which limited knowing which patients developed cancer and the influence of medications on those tumor biomarkers.
The benefits of early diagnosis of ILD in Sjögren’s patients is very clear in terms of early treatment possibilities. Study authors said there is also evidence to suggest that CA153 may be directly involved in the pathogenesis of ILD in Sjögren’s patients. Hopefully, future research will be conducted and result in learning more about how ILD develops and improved options to treat it.
