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肺腺癌 6 与胸部高分辨率 CT 评分在评估间质性肺疾病患者严重程度中的相关性。

Krebs von den Lungen-6 associated with chest high-resolution CT score in evaluation severity of patients with interstitial lung disease.

机构信息

Department of Respiratory, Ren Ji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China.

Department of Clinical Laboratory, Ren Ji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China.

出版信息

Pulmonology. 2019 May-Jun;25(3):143-148. doi: 10.1016/j.pulmoe.2018.05.008. Epub 2018 Jul 11.

DOI:10.1016/j.pulmoe.2018.05.008
PMID:30007895
Abstract

AIMS

The purpose of this prospective, single-center study was to measure the value of Krebs von den Lungen-6 (KL-6), a kind of transmembrane mucoprotein, in diagnosing interstitial lung disease (ILD) and in assessing the severity of ILD.

METHODS

We enrolled 184 patients and 30 healthy controls. Ninety-eight patients were diagnosed with ILD, 47 with pneumonia, 19 with non-small cell lung cancer without ILD (NSCLC/non-ILD) and 20 with other lung diseases. Serum KL-6 levels, CT scores of high-resolution computerised tomography (HRCT) and pulmonary function in ILD patients were assessed.

RESULTS

The mean value of serum KL-6 in patients with ILD, pneumonia, NSCLC/non-ILD, other lung diseases and healthy controls were 1000.67±882.73U/ml, 234.11±91.02U/ml, 269.95±149.23U/ml, 234.85±83.51U/ml and 189.03±55.50U/ml, respectively. Serum KL-6 levels of patients with ILD were significantly higher than that of other groups (P<0.000). The level of serum KL-6 in patients with pneumonia, NSCLC/non-ILD and other lung diseases was also statistically higher than healthy controls (P<0.05). When the cut-off value was 312U/ml, the sensitivity and specificity of KL-6 for the diagnosis of ILD was 84.7% and 85.3% respectively (AUC: 0.936, 95% CI: 0.906-0.965). The serum KL-6 levels in patients with ILD were significantly positively correlated with the CT scores (r=0.539, P=0.000) and negatively correlated with DLCO (r=-0.513, P=0.000).

CONCLUSION

Serum KL-6 might be useful in the diagnosis of ILD, especially in the hard-to-diagnose cases, with high sensitivity and specificity. Furthermore, KL-6 might be a valuable marker for evaluation of ILD severity.

摘要

目的

本前瞻性单中心研究旨在测量 Krebs von den Lungen-6(KL-6)的价值,KL-6 是一种跨膜粘蛋白,用于诊断间质性肺病(ILD)并评估 ILD 的严重程度。

方法

我们纳入了 184 名患者和 30 名健康对照者。98 名患者被诊断为 ILD,47 名为肺炎,19 名为非小细胞肺癌无 ILD(NSCLC/non-ILD),20 名为其他肺部疾病。评估 ILD 患者的血清 KL-6 水平、高分辨率计算机断层扫描(HRCT)的 CT 评分和肺功能。

结果

ILD、肺炎、NSCLC/non-ILD、其他肺部疾病和健康对照组患者的血清 KL-6 平均值分别为 1000.67±882.73U/ml、234.11±91.02U/ml、269.95±149.23U/ml、234.85±83.51U/ml 和 189.03±55.50U/ml。ILD 患者的血清 KL-6 水平明显高于其他组(P<0.000)。肺炎、NSCLC/non-ILD 和其他肺部疾病患者的 KL-6 水平也明显高于健康对照组(P<0.05)。当截断值为 312U/ml 时,KL-6 对 ILD 的诊断灵敏度和特异性分别为 84.7%和 85.3%(AUC:0.936,95%CI:0.906-0.965)。ILD 患者的血清 KL-6 水平与 CT 评分显著正相关(r=0.539,P=0.000),与 DLCO 呈负相关(r=-0.513,P=0.000)。

结论

血清 KL-6 可能对 ILD 的诊断有用,尤其是在难以诊断的病例中,具有较高的灵敏度和特异性。此外,KL-6 可能是评估 ILD 严重程度的有价值的标志物。

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