title: 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.
authors.affiliation: Radiology Unit, Hospital Universitario Polydoro Ernani de São Thiago, Universidade Federal de Santa Catarina (HU-UFSC), Florianópolis, Brazil.
authors.forename: Milene Caroline
authors.initials: MC
authors.lastname: Koch
authors.affiliation: Rheumatology Unit, HU-UFSC, Florianópolis, Brazil.
authors.forename: Ivânio Alves
authors.initials: IA
authors.lastname: Pereira
authors.affiliation: Internal Medicine Department, UFSC, Florianópolis, Brazil.
authors.forename: Luiz Felipe Souza
authors.initials: LF
authors.lastname: Nobre
authors.affiliation: Internal Medicine Department, UFSC, Florianópolis, Brazil. fabricio.souza.neves@gmail.com.|Departamento de Clínica Médica, Hospital Universitário, Universidade Federal de Santa Catarina, 3 Andar, Trindade, Florianópolis, SC, 88040-900, Brazil. fabricio.souza.neves@gmail.com.
authors.forename: Fabricio Souza
authors.initials: FS
authors.lastname: Neves
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001172:Arthritis, Rheumatoid / Q000097:blood / Q000150:complications* / Q000175:diagnosis; D015415:Biomarkers / Q000097:blood; D002272:Carcinoembryonic Antigen / Q000097:blood*; D016009:Chi-Square Distribution; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D018836:Inflammation Mediators / Q000097:blood; D016015:Logistic Models; D008171:Lung Diseases / Q000097:blood / Q000000981:diagnostic imaging* / Q000209:etiology; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D011237:Predictive Value of Tests; D012307:Risk Factors; D014057:Tomography, X-Ray Computed
chemical_list: D015415:Biomarkers; D002272:Carcinoembryonic Antigen; D018836:Inflammation Mediators
keywords: Anti-citrullinated peptide antibodies; Computed tomography; Pulmonary changes; Rheumatoid arthritis; Tumor markers