The Clinical Implications of Serum Carbohydrate Antigen 19-9 Levels in Patients with Nontuberculous Mycobacteria Pulmonary Disease
Abstract
:1. Introduction
2. Methods
2.1. Study Population
2.2. Data Collection
2.3. Measurement of CA 19-9 Levels
2.4. NTM Identification and Microbiological Response
2.5. Statistical Analysis
3. Results
3.1. Comparison of the Characteristics of Patients with and without an Elevated CA19-9
3.2. Microbiological Response in Patients Who Received Antibiotic Therapy
3.3. Factors Associated with Microbiological Cure including CA 19-9 Levels
4. Discussion
Supplementary Materials
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
References
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Characteristics | Total (n = 1112) | Elevated CA 19-9 (n = 322) | Normal CA 19-9 (n = 790) | p-Value |
---|---|---|---|---|
Sex, female | 677 (61) | 228 (71) | 449 (57) | <0.001 |
Age, year | 60 (52–68) | 60 (53–70) | 60 (52–67) | 0.190 |
Body mass index, kg/m2 | 20.7 (19.2–22.5) | 20.3 (18.8–21.9) | 20.9 (19.3–22.9) | 0.001 |
Smoking status | 0.001 | |||
Never | 799 (72) | 256 (80) | 543 (69) | |
Ex | 283 (25) | 62 (19) | 221 (28) | |
Current | 30 (3) | 4 (1) | 26 (3) | |
Comorbidity | ||||
Bronchiectasis | 922 (83) | 299 (93) | 623 (79) | <0.001 |
Previous pulmonary tuberculosis | 414 (37) | 121 (38) | 293 (37) | 0.878 |
Other malignancy | 172 (16) | 39 (12) | 133 (17) | 0.048 |
Obstructive lung disease | 82 (7) | 18 (6) | 64 (8) | 0.146 |
Chronic pulmonary aspergillosis | 24 (2) | 5 (2) | 19 (2) | 0.375 |
Idiopathic pulmonary fibrosis | 12 (1) | 5 (2) | 7 (1) | 0.344 |
Lung cancer | 12 (1) | 3 (1) | 9 (1) | 1.000 |
Positive sputum AFB smear | 482 (43) | 143 (44) | 339 (43) | 0.647 |
Radiological form | <0.001 | |||
Nodular bronchiectatic form | 902 (81) | 297 (92) | 605 (77) | |
Fibrocavitary form | 154 (14) | 20 (6) | 134 (17) | |
Non-classifiable form | 56 (5) | 5 (2) | 51 (7) | |
Cavity | 259 (23) | 64 (20) | 195 (25) | 0.085 |
Etiology | ||||
M. avium complex | 797 (72) | 209 (65) | 588 (74) | 0.001 |
M. massiliense | 109 (10) | 37 (12) | 72 (9) | 0.227 |
M. abscessus | 103 (9) | 45 (14) | 58 (7) | 0.001 |
Mixed | 59 (5) | 21 (7) | 38 (5) | 0.248 |
Others | 44 (4) | 10 (3) | 34 (4) | 0.353 |
Laboratory test | ||||
ESR, mm/h (n = 811) | 27 (15–47) | 31 (18–54) | 26 (14–45) | <0.001 |
CRP, mg/dL (n = 906) | 0.13 (0.05–0.68) | 0.16 (0.06–0.68) | 0.12 (0.05–0.70) | 0.029 |
Initiation of antibiotic treatment | 688 (62) | 239 (74) | 449 (57) | <0.001 |
BACES severity score (n = 811) ¶ | 0.842 * | |||
Mild | 360 (44) | 116 (46) | 244 (44) | |
Moderate | 372 (46) | 115 (45) | 257 (46) | |
Severe | 79 (10) | 23 (9) | 56 (10) |
Variables | Total (n = 688) | Elevated CA 19-9 (n = 239) | Normal CA 19-9 (n = 449) | p-Value |
---|---|---|---|---|
Treatment duration, month | 19.4 (15.2–24.5) | 19.0 (15.2–24.5) | 19.6 (15.2–24.6) | 0.949 |
Culture conversion, within one year | 437/583 (75) | 164/206 (80) | 273/377 (72) | 0.055 |
Microbiological cure | 466/551 (85) | 175/197 (89) | 291/354 (82) | 0.039 |
Time to culture conversion, month ¶ | 1.2 (0.9–5.0) | 1.4 (0.9–5.8) | 1.2 (0.9–4.5) | 0.338 |
Variables | Univariate Analysis | Multivariate Analysis | ||
---|---|---|---|---|
Odd Ratio (95% Confidence Interval) | p-Value | Adjusted Odd Ratio (95% Confidence Interval) | p-Value | |
Sex, female | 1.934 (1.209–3.095) | 0.006 | – | – |
Age, year | 0.985 (0.964–1.006) | 0.162 | – | – |
Body mass index, kg/m2 | 1.043 (0.948–1.147) | 0.389 | – | – |
Smoking status | ||||
Never | reference | – | reference | – |
Ex | 0.625 (0.369–1.059) | 0.081 | 0.617 (0.313–1.216) | 0.163 |
Current | 0.395 (0.120–1.301) | 0.127 | 0.159 (0.037–0.686) | 0.014 |
Comorbidities | ||||
Bronchiectasis | 0.748 (0.338–1.439) | 0.384 | 0.358 (0.153–0.837) | 0.018 |
Obstructive lung disease | 1.250 (0.545–2.867) | 0.598 | – | – |
Chronic pulmonary aspergillosis | 1.285 (0.287–5.761) | 0.743 | – | – |
Idiopathic pulmonary fibrosis | 1.281 (0.156–10.547) | 0.818 | – | – |
Previous pulmonary tuberculosis | 0.603 (0.378–0.960) | 0.033 | – | – |
Positive sputum AFB smear | 0.370 (0.223–0.615) | <0.001 | 0.289 (0.155–0.541) | <0.001 |
Cavity | 0.836 (0.514–1.360) | 0.471 | – | – |
Etiology | ||||
M. avium complex | 1.364 (0.846–2.199) | 0.203 | – | – |
M. massiliense | 3.520 (1.249–9.917) | 0.017 | 3.108 (1.055–9.150) | 0.040 |
M. abscessus | 0.329 (0.172–0.629) | 0.001 | 0.329 (0.147–0.735) | 0.007 |
Laboratory findings | ||||
ESR, mm/h | 1.004 (0.995–1.014) | 0.367 | – | – |
CRP, mg/dL | 0.918 (0.809–1.043) | 0.189 | – | – |
CA 19-9 (U/mL) | 1.002 (0.999–1.005) | 0.262 | 1.004 (0.999–1.008) | 0.121 |
BACES severity score ¶ | ||||
Mild | reference | – | reference | – |
Moderate | 0.838 (0.492–1.426) | 0.514 | – | – |
Severe | 0.563 (0.233–1.358) | 0.201 | – | – |
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Lee, D.; Jhun, B.W. The Clinical Implications of Serum Carbohydrate Antigen 19-9 Levels in Patients with Nontuberculous Mycobacteria Pulmonary Disease. J. Clin. Med. 2023, 12, 7751. https://doi.org/10.3390/jcm12247751
Lee D, Jhun BW. The Clinical Implications of Serum Carbohydrate Antigen 19-9 Levels in Patients with Nontuberculous Mycobacteria Pulmonary Disease. Journal of Clinical Medicine. 2023; 12(24):7751. https://doi.org/10.3390/jcm12247751
Chicago/Turabian StyleLee, Daegeun, and Byung Woo Jhun. 2023. "The Clinical Implications of Serum Carbohydrate Antigen 19-9 Levels in Patients with Nontuberculous Mycobacteria Pulmonary Disease" Journal of Clinical Medicine 12, no. 24: 7751. https://doi.org/10.3390/jcm12247751