Tajiri Morihiro, Okamoto Masaki, Fujimoto Kiminori, Johkoh Takeshi, Ono Junya, Tominaga Masaki, Azuma Koichi, Kawayama Tomotaka, Ohta Shoichiro, Izuhara Kenji, Hoshino Tomoaki
Division of Respirology, Neurology, and Rheumatology, Department of Internal Medicine, Kurume University School of Medicine, 67 Asahi-machi, Kurume, Fukuoka 830-0011, Japan.
Department of Radiology and Center for Diagnostic Imaging, Kurume University School of Medicine, 67 Asahi-machi, Kurume, Fukuoka 830-0011, Japan.
Respir Investig. 2015 Mar;53(2):73-81. doi: 10.1016/j.resinv.2014.12.003. Epub 2015 Jan 19.
KL-6 and surfactant proteins A and D are the only established serum biomarkers of idiopathic pulmonary fibrosis (IPF). We have previously shown that serum levels of periostin, a unique matricellular protein, are elevated and correlated with pulmonary function in patients with IPF. We sought to determine whether the serum periostin levels correlate with overall survival (OS) and time-to-event (TTE), as a parameter reflecting long-term outcome, and with the extent of abnormality on chest high-resolution computed tomography (HRCT) scores in patients with IPF.
Twenty-nine patients with IPF were analyzed retrospectively. The mean observation period was 1035.2 ± 663.1 days (range, 112-1800 days). High-resolution computed tomography (HRCT) scores were calculated based on the extent of abnormality evidenced by HRCT. We evaluated if there were any correlations between the serum periostin levels and clinical parameters, including HRCT score, using Spearman's rank correlation coefficients and analyzed predictors of OS and TTE using the log-rank tests.
We showed that the serum periostin levels significantly correlated with the increase of honeycombing score on HRCT during a 6-month period. Log-rank tests showed that a higher serum periostin level was a predictor of a shortened OS and TTE. Greater extents of fibrotic lesions on HRCT scan were predictors of shortened OS and TTE.
In IPF patients, the serum periostin level may be a good predictive biomarker for an increase in the radiological fibrotic area and long-term outcome.
KL-6以及表面活性蛋白A和D是目前已知的特发性肺纤维化（IPF）仅有的血清生物标志物。我们之前已经表明，骨膜蛋白（一种独特的基质细胞蛋白）的血清水平在IPF患者中升高，并且与肺功能相关。我们试图确定血清骨膜蛋白水平是否与总生存期（OS）和事件发生时间（TTE，作为反映长期预后的一个参数）相关，以及是否与IPF患者胸部高分辨率计算机断层扫描（HRCT）评分的异常程度相关。
对29例IPF患者进行回顾性分析。平均观察期为1035.2±663.1天（范围112 - 1800天）。基于HRCT显示的异常程度计算高分辨率计算机断层扫描（HRCT）评分。我们使用Spearman等级相关系数评估血清骨膜蛋白水平与包括HRCT评分在内的临床参数之间是否存在任何相关性，并使用对数秩检验分析OS和TTE的预测因素。
我们发现血清骨膜蛋白水平与6个月期间HRCT上蜂窝状评分的增加显著相关。对数秩检验表明，较高的血清骨膜蛋白水平是OS和TTE缩短的一个预测因素。HRCT扫描上更大范围的纤维化病变是OS和TTE缩短的预测因素。
在IPF患者中，血清骨膜蛋白水平可能是放射学纤维化面积增加和长期预后的一个良好预测生物标志物。
