Abstract:

Objective To clarify the changes in the expression levels of tumor markers in the serum of patients with occupational pneumoconiosis and deeply analyze the various influencing factors that cause these changes. Methods judgment sampling method was used to select 255 patients with occupational pneumoconiosis who visited the Occupational Disease Department of Guangdong Provincial Institute for Occupational Disease Prevention and Control from January 2021 to December 2023 as the research subjects. They were divided into stage Ⅰ，stageⅡ and stage Ⅲgroups according to the stage of pneumoconiosis，into silicosis and non-silicosis groups according to whether they had silicosis，and into 0-<6，6-<11，11-<21 and ≥21 years groups according to the duration of the disease. The peripheral blood was collected from the patients to detect the levels of neuron-specific enolase（NSE），cytokeratin-19-fragment（CYFRA21-1），pro-gastrin-releasing peptide（ProGRP），and alpha-fetoprotein（AFP）. A multiple linear regression model was used to analyze the influencing factors of serum tumor marker indicators. Results There were statistically significant differences in gender distribution，age，dust exposure time，duration of diagnosis，and mask wearing rate among patients of different stages（all P<0.05）. There were statistically significant differences in dust exposure time，age at first dust exposure，and noise exposure rate between silicosis and non-silicosis patients（all P<0.05）. There were statistically significant differences in duration of diagnosis，age at diagnosis，age at first dust exposure，mask wearing rate，and noise exposure rate among patients with different disease durations（all P<0.05）. The abnormal rate and level of serum NSE in patients with occupational pneumoconiosis increased with the increase of pneumoconiosis stage，and there were significant differences among different stages（all P<0.05）. The abnormal rate and level of serum CYFRA21-1 in patients of stageⅡand stageⅢ pneumoconiosis were higher than those in stageⅠ（all P<0.05）. Compared with the 0-<6 years group，the level of serum CYFRA21-1 in the 11-<21 years group was significantly increased（P<0.05）. The level of serum AFP in non-silicosis patients was higher than that in silicosis patients（P<0.05）. The results of multiple linear regression analysis showed that the stage of pneumoconiosis was an influencing factor for the levels of serum NSE and CYFRA21-1（all P<0.05），the age at first dust exposure，whether it was silicosis，smoking and stage of pneumoconiosis were influencing factors for the level of serum ProGRP（all P<0.05），and the age at first dust exposure， gender，and whether it was silicosis were influencing factors for the level of serum AFP（all P<0.05）. Conclusion The levels of serum tumor markers in occupational pneumoconiosis patients are regulated by disease stage，type，age and smoking，and their dynamic changes can provide an important reference for disease monitoring.

Key words: Occupational pneumoconiosis, Tumor markers, Neuron-specificenolase, Cytokeratin-19-fragment, Influencing factor