Computed tomography of pulmonary changes in rheumatoid arthritis: carcinoembryonic antigen (CEA) as a marker of airway disease

Abstract

Rheumatoid arthritis (RA) classically affects the joints, but can present extra-articular manifestations, including pulmonary disease. The present study aimed to identify possible risk factors or laboratory markers for lung involvement in RA, particularly the presence of rheumatoid factor (RF), anti-citrullinated peptide antibodies (ACPA), and tumor markers, by correlating them with changes observed on chest high-resolution computerized tomography (HRCT). This cross-sectional study involved RA patients who were examined and questioned by a specialist physician and later subjected to chest HRCT and blood collection for measurement of C-reactive protein (CRP), erythrocyte sedimentation rate (ESR), rheumatoid factor (RF), ACPA (anti-vimentin and/or anti-CCP3), and the tumor markers carcinoembryonic antigen (CEA), CA 125, CA 15-3, and CA 19-9. A total of 96 patients underwent chest HRCT. The most frequent findings were bronchial thickening (27/28.1 %) and bronchiectasis (25/26 %). RF was present in 63.2 % of patients (55/87), and ACPA (anti-vimentin or anti-CCP3) was present in 72.7 % of patients (64/88). CEA levels were high in 14 non-smokers (37.8 %) and 23 smokers (62.2 %). CA-19-9 levels were high in 6 of 86 patients (7.0 %), CA 15-3 levels were high in 3 of 85 patients (3.5 %), and CA 125 levels were high in 4 of 75 patients (5.3 %). Multivariate analysis indicated a statistically significant association between high CEA levels and the presence of airway changes in patients with RA (p = 0.048). CEA can serve as a predictor of lung disease in RA and can help identify individuals who require more detailed examination for the presence of respiratory disorders.

Carcinoembryonic Antigen: A Predictor of Inflammatory Condition in Patients with Allergic Bronchopulmonary Aspergillosis?

“…Studies have reported that high CEA levels in serum and bronchoalveolar lavage uid might connected with mucous embolism in asthma patients 17,18 . Milene Caroline Koch al have also shown that increase CEA levels associated with airway changes in rheumatoid arthritis patients such as bronchial wall thickening, bronchiectasis and nodules 19 . Recent studies have shown that the clinical characteristics and prognosis of ABPA are closely related to the mucus plugs in central bronchiectasis 20 .…”

Postoperative carcinoembryonic antigen (CEA) levels predict outcomes after resection of colorectal cancer in patients with normal preoperative CEA levels

“…The CEA level detected recurrent disease 2 to 5 months prior to discovery by any other means ( 23 , 24 ). Any rise in CEA level higher than 10 ng/mL should prompt thorough assessment for disease recurrence; however, false-positive elevated CEA levels have been reported to occur in patients who are smokers and patients with inflammatory states, including chronic obstructive lung diseases ( 25 ) and rheumatoid arthritis ( 26 ). In addition, the CEA level is not specific to CRC and could be elevated in many other cancers.…”

A causal relationship between rheumatoid arthritis and bronchiectasis? A systematic review and meta-analysis

“…In terms of causality, no studies claim to present proof of causality between BE and RA. Sixteen of the included studies self-report as negative studies, 6,14,22,24,26,28,29,30,34,38,39,41,43,44,48,50 while five studies suggested associations based on biological/biochemical processes, 18,21,27,45,51 four based on (temporality of) symptoms 16,25,46,47 and three based on prevalence of radiographic findings. 19,32,36…”