Shimizu Y, Tanaka Y, Sasaki A, Nemoto T
Department of Internal Medicine, Nanokaichi Municipal Hospital, 643 Nanokaichi, Tomioka, Gunma 370-2343, Japan.
Nihon Kokyuki Gakkai Zasshi. 2001 May;39(5):351-6.
A 73-year-old woman with CA19-9-producing idiopathic interstitial pneumonia was admitted to the hospital when her condition was exacerbated. Chest radiography and computed tomography showed an additional patchy shadow. The serum CA19-9 level remained high during the clinical course, whereas KL-6 increased only at exacerbation. No therapy was effective, and the patient died 5 days later. The lung obtained at autopsy showed hyaline membrane formation, hemorrhage, and squamous metaplasia, suggesting that acute exacerbation had resulted in diffuse alveolar damage. Immunohistochemical staining using either anti-CA19-9 mAb or anti-KL-6 mAb showed the localization of CA19-9 and KL-6 antigen in the dilated bronchiolar epithelial cells. In conclusion, although CA19-9 can be an indicator for the degree of fibrotic and destructive change of lung structure, KL-6 seemed more sensitively to reflect the disease state of the diffuse alveolar damage.
一名73岁患有产生CA19-9的特发性间质性肺炎的女性在病情加重时入院。胸部X线摄影和计算机断层扫描显示有新增的斑片状阴影。在临床病程中，血清CA19-9水平持续升高，而KL-6仅在病情加重时升高。没有治疗方法有效，患者5天后死亡。尸检获得的肺显示有透明膜形成、出血和鳞状化生，提示急性加重导致了弥漫性肺泡损伤。使用抗CA19-9单克隆抗体或抗KL-6单克隆抗体进行免疫组织化学染色显示，CA19-9和KL-6抗原定位于扩张的细支气管上皮细胞中。总之，虽然CA19-9可以作为肺结构纤维化和破坏程度的指标，但KL-6似乎更能敏感地反映弥漫性肺泡损伤的疾病状态。
