Abstract
BACKGROUND: Allergic bronchopulmonary aspergillosis/mycosis (ABPA/M) is a complex non-infectious pulmonary benign disease characterized by an immune response against aspergillus/fungus. Carcinoembryonic antigen (CEA), typically recognized as a tumor marker, also elevated in certain benign diseases. Few studies on ABPA/M cases presenting with elevated serum CEA levels have been reported. PATIENTS AND METHODS: A cohort of 115 patients diagnosed as ABPA/M were divided into two groups (CEA normal and CEA elevated). The characteristics of ABPA/M patients in terms of its demographic profile, clinical symptoms, pertinent clinical laboratory examinations were analyzed. Levels of cytokines (IL-4, IL-5, GM-CSF, IFN-γ) were analyzed by enzyme-linked immunosorbent assay. Comparative evaluation included pre-therapy and post-treatment eosinophil count and total IgE level, to evaluate therapeutic disparities between the two groups. RESULTS: Among 115 cases of ABPA/M, 32 exhibited elevated serum CEA levels above baseline and 83 were normal. ABPA/M patients with elevated serum CEA tended to be younger (50, IQR [43-56] years vs 59, IQR [47-68] years; P < 0.05) with superior pulmonary function (FEV1/FVC ratio, 65.1% (44.2, 79.6) vs 79.1% (65.2, 84.2), P < 0.05), and showed marginally higher baseline levels of the total IgE (P < 0.05), blood eosinophils counts and ratios (P < 0.01) compared to those with normal CEA. Higher serum levels of IL-4, IL-5, GM-CSF and IFN-γ in ABPA/M patients with elevated serum CEA levels were observed (P < 0.0001). After treatment (at 12w), compared to ABPA/M patients with normal serum CEA, the decrease in eosinophil count and total IgE levels was less pronounced in ABPA/M patients with elevated serum CEA eosinophil count, 523±481.66 vs 267±200.68, P < 0.05; total IgE, 619±680.47 vs 263±400.90, P < 0.05), which indicates a poor response to treatment. CONCLUSION: Monitoring serum CEA levels may serve as a supplementary tool in the clinical management of ABPA/M patients.