Department of Radiology, Oita University Faculty of Medicine, Oita, Japan.
Br J Radiol. 2011 Mar;84(999):229-35. doi: 10.1259/bjr/65287605. Epub 2010 Nov 2.
This study aimed to compare thin-section CT images from sarcoidosis patients who had either normal or elevated serum KL-6 levels.
101 patients with sarcoidosis who underwent thin-section CT examinations of the chest and serum KL-6 measurements between December 2003 and November 2008 were retrospectively identified. The study group comprised 75 sarcoidosis patients (23 male, 52 female; aged 19-82 years, mean 54.1 years) with normal KL-6 levels (152-499 U ml(-1), mean 305.7 U ml(-1)) and 26 sarcoidosis patients (7 male, 19 female; aged 19-75 years, mean 54.3 years) with elevated KL-6 levels (541-2940 U ml(-1), mean 802.4 U ml(-1)). Two chest radiologists, unaware of KL-6 levels, retrospectively and independently interpreted CT images for parenchymal abnormalities, enlarged lymph nodes and pleural effusion.
CT findings in sarcoidosis patients consisted mainly of lymph node enlargement (70/75 with normal KL-6 levels and 21/26 with elevated KL-6 levels), followed by nodules (50 and 25 with normal and elevated levels, respectively) and bronchial wall thickening (25 and 21 with normal and elevated levels, respectively). Ground-glass opacity, nodules, interlobular septal thickening, traction bronchiectasis, architectural distortion and bronchial wall thickening were significantly more frequent in patients with elevated KL-6 levels than those with normal levels (p<0.001, p<0.005, p<0.001, p<0.001, p<0.001 and p<0.001, respectively). By comparison, there was no significant difference in frequency of lymph node enlargement between the two groups.
These results suggest that serum KL-6 levels may be a useful marker for indicating the severity of parenchymal sarcoidosis.
本研究旨在比较血清 KL-6 水平正常和升高的结节病患者的薄层 CT 图像。
回顾性分析 2003 年 12 月至 2008 年 11 月期间接受胸部薄层 CT 检查和血清 KL-6 测量的 101 例结节病患者。研究组包括 75 例血清 KL-6 水平正常（152-499U/ml，平均 305.7U/ml）的结节病患者（男 23 例，女 52 例；年龄 19-82 岁，平均 54.1 岁）和 26 例血清 KL-6 水平升高（541-2940U/ml，平均 802.4U/ml）的结节病患者（男 7 例，女 19 例；年龄 19-75 岁，平均 54.3 岁）。两名胸部放射科医生在不知晓 KL-6 水平的情况下，对 CT 图像进行回顾性和独立判读，评估实质异常、淋巴结肿大和胸腔积液情况。
结节病患者的 CT 表现主要为淋巴结肿大（70/75 例血清 KL-6 水平正常和 21/26 例血清 KL-6 水平升高），其次为结节（50 例和 25 例，分别为正常和升高水平）和支气管壁增厚（25 例和 21 例，分别为正常和升高水平）。与血清 KL-6 水平正常者相比，血清 KL-6 水平升高者的磨玻璃影、结节、小叶间隔增厚、牵引性支气管扩张、结构扭曲和支气管壁增厚更为常见（p<0.001、p<0.005、p<0.001、p<0.001、p<0.001 和 p<0.001）。相比之下，两组淋巴结肿大的发生率无显著差异。
这些结果表明，血清 KL-6 水平可能是提示肺结节病实质严重程度的有用标志物。
