CA 15-3 como marcador de atividade e gravidade na pneumonite de hipersensibilidade crônica

• Ano de defesa: 2019
• Autor(a) principal: Gomes, Paula Silva [UNIFESP]
• Tipo de documento: Tese
• Tipo de acesso: Acesso aberto
• Idioma: por
• Instituição de defesa: Universidade Federal de São Paulo (UNIFESP)
• Palavras-chave em Português: Hypersensitivity Pneumonitis; Biomarkers; C.A.15-4; In Interstitial Lung Diseases; Pneumonite De Hipersensibilidade; Biomarcadores; Doenças Pulmonares Intersticiais
• Link de acesso: https://sucupira.capes.gov.br/sucupira/public/consultas/coleta/trabalhoConclusao/viewTrabalhoConclusao.jsf?popup=true&id_trabalho=7657271; https://repositorio.unifesp.br/handle/11600/59239

Objective: Assess CA 15-3 as severity and activity marker in chronic hypersensitivity pneumonitis (cHP). Methods: Forty-one adults diagnosed according Salisbury’s criteria were evaluated in a cross-sectional study. Patients with other causes that could lead to high serum levels of CA 15-3 or dyspnea were excluded. Serum levels of CA 15-3 were: 1) Compared between patients with and without disease activity (based on progressive worsening of the dyspnea or significant worsening of lung function in the last 6-12 months before the study enrollment); 2) Correlated with functional severity indicators; 3) Compared between CT semi-quantitative scores set by two expert radiologists and; 4) Compared between patients removed from antigen exposure and others. Results: median age was 70.2 ± 17.34 years; Mean FVC% was 60.9±11.5. Environmental exposure was presented in all cases. Serum levels of CA 15-3 were higher in patients with active disease (Md= 73,2, Q1=34,7-Q3=141,6 vs Md= 38,8, Q1=25,7-Q3=60,9, p=0,02) in those out of activity. The cut-off point of CA 15-3 obtained using ROC curve was 51 U/mL (t=6,16, p=0,01). CA 15-3 were negatively correlated with: FVC% (r =-0,30, p=0,05), DLCO% (r =-0,52, p<0,01) e Exercise SpO2 (r =-0,59, p<0,01). There was a direct correlation between CA 15-3 and semiquantitative score of ground-glass opacities extension (F=3,03, p=0,04). There was no correlation with score fibrosis. Patients improved after withdrawal of exposure had lower values of CA 15-3 than those maintained it and worsened and the best point of cut-off was 55 U/mL (AUC=0,73, p=0,01). Conclusion: CA 15-3 is a promising biomarker in HP chronic disclosing direct correlation with disease severity, particularly with gas exchange and activity.