初治特发性肺纤维化患者血清肿瘤标志物Krebs von den Lungen-6水平与高分辨率胸部CT纤维化评分及肺功能参数的相关性
Correlation of serum Krebs von den Lungen-6 levels with fibrosis score on high resolution chest tomography and pulmonary function parameters in treatment naïve Idiopathic Pulmonary Fibrosis.
作者信息
Sanjan Ganesh, Sharma Prakhar, Banerjee Saikat, Sivaramakrishnan Prakash, Sherwani Poonam, Atif Mirza Anissa, Sindhwani Girish, Arvind Bahurupi Yogesh
机构信息
Department of Pulmonary Medicine, All India Institute of Medical Sciences Rishikesh, Dehradun, 249203, Uttarakhand, India.
Department of Radiology, All India Institute of Medical Sciences Rishikesh, Dehradun, 249203, Uttarakhand, India.
出版信息
Sarcoidosis Vasc Diffuse Lung Dis. 2024 Sep 24;41(3):e2024044. doi: 10.36141/svdld.v41i3.15689.
BACKGROUND
While serum Krebs von den Lungen-6 (KL-6) has been found to be a helpful biomarker in interstitial lung diseases for evaluating disease severity and progression, especially in connective tissue disease-associated interstitial lung disease (CTD ILD) and idiopathic non-specific interstitial pneumonia (NSIP), data on correlation of serum KL-6 levels with radiological fibrosis and pulmonary function parameters is lacking in treatment naïve Idiopathic Pulmonary Fibrosis (IPF) patients.
METHODS
Serum KL-6 levels were measured in thirty-nine treatment naïve newly detected IPF patients using automated immunofluorescence enzyme assay (AIA) by Tosoh Corporation, bioscience division, Tokyo, Japan. Fibrosis score was calculated by independent visual assessment of the pattern and severity of abnormalities on high resolution computed tomography (HRCT) thorax. HRCT fibrosis scores were correlated with serum KL-6 levels and pulmonary function parameters like forced vital capacity (FVC), diffusion capacity of lung for carbon monoxide (DLco).
RESULTS
Median value of serum KL-6 levels was 1519 U/ml (range 199.41-6055 U/ml). There was positive correlation of serum KL-6 with HRCT fibrosis score (r=0.692, p<0.001) and negative correlation with FVC (r=-0.511, p=0.001) and DLco (r=-0.354, p=0.043). In the HRCT fibrosis score pattern subset analysis, the presence of reticulation revealed weak negative and statistically insignificant correlation (r=-0.116, p=0.481) while traction bronchiectasis and honeycombing exhibited statistically significant positive correlation (r=0.425, p=0.007; r=0.584, p<0.001 respectively) with serum KL-6 levels.
CONCLUSION
Serum KL-6 levels showed a positive correlation with the degree of fibrotic abnormalities on HRCT thorax and pulmonary function parameters, indicating a potential use of serum KL-6 in monitoring of parenchymal fibrosis in Idiopathic Pulmonary fibrosis.
背景
虽然血清克雷布斯-冯-登-卢肯斯6（KL-6）已被发现是间质性肺疾病中评估疾病严重程度和进展的有用生物标志物，特别是在结缔组织病相关间质性肺病（CTD-ILD）和特发性非特异性间质性肺炎（NSIP）中，但在未经治疗的特发性肺纤维化（IPF）患者中，血清KL-6水平与放射学纤维化和肺功能参数之间的相关性数据尚缺乏。
方法
使用日本东京生物科学部门东曹公司的自动免疫荧光酶法（AIA），对39例未经治疗的新诊断IPF患者测量血清KL-6水平。通过对胸部高分辨率计算机断层扫描（HRCT）上异常的模式和严重程度进行独立视觉评估来计算纤维化评分。HRCT纤维化评分与血清KL-6水平以及肺功能参数如用力肺活量（FVC）、肺一氧化碳弥散量（DLco）相关。
结果
血清KL-6水平的中位数为1519 U/ml（范围199.41-6055 U/ml）。血清KL-6与HRCT纤维化评分呈正相关（r=0.692，p<0.001），与FVC呈负相关（r=-0.511，p=0.001），与DLco呈负相关（r=-0.354，p=0.043）。在HRCT纤维化评分模式亚组分析中，网状结构的存在显示出弱的负相关且无统计学意义（r=-0.116，p=0.481），而牵拉性支气管扩张和蜂窝状改变与血清KL-6水平呈统计学显著正相关（分别为r=0.425，p=0.007；r=0.584，p<0.001）。
结论
血清KL-6水平与胸部HRCT上纤维化异常程度及肺功能参数呈正相关，表明血清KL-6在特发性肺纤维化实质纤维化监测中具有潜在用途。
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