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THU0197 Tumour-associated antigens in rheumatoid arthritis
  1. P Athanassiou1,
  2. A Elezoglou1,
  3. I Kostoglou-Athanassiou2,
  4. A Theodorou1,
  5. P Konstantopoulou1,
  6. A Kotrotsios1,
  7. P Dimou3,
  8. G Vezyroglou1
  1. 1Department of Rheumatology
  2. 2Department of Endocrinology, Metaxa Hospital, Pireaus, Greece
  3. 3Department of Biochemistry, Asklepieion Hospital, Voula, Athens

Abstract

Background Rheumatoid arthritis (RA) is characterised by aberrations of the immune system. Moreover, treatment of RA patients involves agents, which induce immunosuppression. However, it has not yet been clarified whether RA or its primary treatment predispose to the development of malignancy.

Objectives The aim was to investigate tumour-associated antigens and other markers of malignancy in patients with RA.

Methods Patients with RA, n = 38, aged 59.0 ± 2.0 years (mean ± SEM), duration of disease 8.1 ± 1.1 years were studied. Patients with osteoarthritis (OA), n = 38, were also studied. None of the patients had any known malignancy. All patients had a complete physical examination when entering the study. In all patients levels of haematocrit, haemoglobin, erythrocyte sedimentation rate, C-reactive protein, rheumatoid factor and alkaline phosphatase were measured. All patients were tested for positivity for antinuclear antibodies (ANA). In all patients levels of carcinoembryonic antigen (CEA), a-fetoprotein, b2-microglobulin, CA 15 – 3, CA 125 and CA 19 – 9 were measured.

Results In patients with RA haematocrit was 35.3 ± 0.5% (mean ± SEM), haemoglobin 11.2 ± 0.2 g/dl, C-reactive protein 54.7 ± 6.5 mg/l and rheumatoid factor 197.6 ± 34.9 iu/ml. In patients with OA haematocrit was 39.0 ± 0.7%, haemoglobin 12.4 ± 0.2 g/dl, C-reactive protein 23.4 ± 4.9 mg/l and rheumatoid factor 10.6 ± 0.2 iu/ml. In patients with RA and OA CEA levels were 1.4 ± 0.1 ng/ml and 2.2 ± 0.2 ng/ml, respectively (normal range <5.0 ng/ml, Student’s t test p < 0.05). In RA and OA patients a-fetoprotein levels were 3.1 ± 0.2 ng/ml and 4.0 ± 0.3 ng/ml, respectively (normal range <8.6 ng/ml). In RA and OA b2-microglobulin levels were 1.7 ± 0.1 mg/l and 1.6 ± 0.1 mg/l, respectively. There was no difference in the levels of any of the specific tumour-associated antigens between the groups of patients with RA and OA. In RA and OA patients CA 15 – 3 levels were 19.1 ± 0.8 u/ml and 18.2 ± 1.0 u/ml, respectively (normal range <28 u/ml, p > 0.05). In RA and OA patients CA 125 levels were 9.5 ± 0.9 u/ml and 7.0 ± 0.5 u/ml, respectively (normal range <35 u/ml, p > 0.05). In RA and OA CA 19 – 9 levels were 9.3 ± 1.4 u/ml and 9.7 ± 1.3 u/ml, respectively (normal range <37 u/ml, p > 0.05).

Conclusion In RA patients CEA levels were found to be lower than those of OA patients, being however in the normal range for both groups. Levels of tumour-associated antigens were found to be in the normal range in RA and OA patients, no significant difference being observed between the groups. It appears that in RA no significant alteration of the levels of tumour-associated antigens is observed. Additionally, in the population of patients studied RA did not appear to predispose to the development of malignancy. More studies are needed in order to find the effect of RA and its primary treatment on the development of malignancy.

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