Guo Jiaxi, Huang Heqing, Lin Shaowei, Wang Guangdong, Cen Fengbei, Huang Shenhui, Liu Dehao, Lin Yikai, Yu Xinhua, Shi Sien, Ma Aiping
Department of Respiratory and Critical Medicine, School of Medicine, The First Affiliated Hospital of Xiamen University, Xiamen University, NO.55 ZhenHai Road, Xiamen, 361001, China.
Department of Rheumatology, School of Medicine, The First Affiliated Hospital of Xiamen University, Xiamen University, Xiamen, China.
BMC Pulm Med. 2025 Mar 7;25(1):102. doi: 10.1186/s12890-025-03558-4.
The objective of this study was to evaluate the clinical significance of carbohydrate antigen (CA) 153 and its correlation with Krebs von den Lungen-6 (KL-6) in the prediction and determination of the severity of interstitial lung disease (ILD) in rheumatoid arthritis (RA) patients.
Data was collected retrospectively on a cohort of 357 RA patients who were admitted to our hospital from January 2018 to December 2020. The classification of patients into subgroups was based on high-resolution computed tomography (HRCT) of the chest, resulting in 135 patients with RA but no ILD, 107 patients with RA and indeterminate ILD, 91 patients with RA and mild ILD, and 24 patients with RA and advanced ILD. The levels of CA153 and KL-6 were determined by chemiluminescence analysis.
The serum levels of CA153 were found to be significantly higher in both the RA-mild ILD group and the RA-advanced ILD group compared to the RA-no ILD group (8.00 vs. 6.40, q = 0.039; 20.30 vs. 6.40, q < 0.001). Multivariate analysis demonstrated that CA153 was an independent risk factor for RA-ILD (RA-mild ILD + RA-advanced ILD) [odds ratio (OR) = 1.124, 95% confidence interval (CI) = (1.060-1.191), p < 0.001] and RA-advanced ILD (OR = 1.583, 95% CI = 1.247-2.010, p < 0.001). Furthermore, the receiver operating characteristic (ROC) analysis indicated that CA153 had diagnostic value for both RA-ILD (RA-mild ILD + RA-advanced ILD) and RA-advanced ILD. The best area under ROC curve (AUC) of CA153 for RA-ILD (RA-mild ILD + RA-advanced ILD) was 0.66 (p < 0.001; sensitivity = 57.27%; specificity = 72.03%). The AUC of CA153 for RA-advanced ILD was 0.95 (p < 0.001; sensitivity = 95.65%; specificity = 83.05%). Moreover, CA153 was negatively correlated with forced vital capacity percent predicted (FVC% pred) (r = -0.383, p = 0.037) but positively related to KL-6 (r = 0.762, p < 0.001).
It was concluded that CA153 was positively associated with KL-6 and might be a significant and clinical availably measurable serum marker to predict the diagnosis and severity of ILD in RA patients.
本研究旨在评估糖类抗原（CA）153的临床意义及其与克雷伯氏肺炎-6（KL-6）在预测和判定类风湿关节炎（RA）患者间质性肺病（ILD）严重程度方面的相关性。
回顾性收集2018年1月至2020年12月期间我院收治的357例RA患者的数据。根据胸部高分辨率计算机断层扫描（HRCT）将患者分为亚组，其中135例RA但无ILD患者，107例RA且ILD不明确患者，91例RA且轻度ILD患者，以及24例RA且重度ILD患者。通过化学发光分析测定CA153和KL-6水平。
与RA无ILD组相比，RA轻度ILD组和RA重度ILD组的血清CA153水平均显著升高（8.00对6.40，q = 0.039；20.30对6.40，q < 0.001）。多因素分析表明，CA153是RA-ILD（RA轻度ILD + RA重度ILD）的独立危险因素[比值比（OR）= 1.124，95%置信区间（CI）=（1.060 - 1.191），p < 0.001]以及RA重度ILD的独立危险因素（OR = 1.583，95% CI = 1.247 - 2.010，p < 0.001）。此外，受试者工作特征（ROC）分析表明，CA153对RA-ILD（RA轻度ILD + RA重度ILD）和RA重度ILD均具有诊断价值。CA153对RA-ILD（RA轻度ILD + RA重度ILD）的最佳ROC曲线下面积（AUC）为0.66（p < 0.001；灵敏度 = 57.27%；特异性 = 72.03%）。CA153对RA重度ILD的AUC为0.95（p < 0.001；灵敏度 = 95.65%；特异性 = 83.05%）。此外，CA153与预计用力肺活量百分比（FVC% pred）呈负相关（r = -0.383，p = 0.037），但与KL-6呈正相关（r = 0.762，p < 0.001）。
得出结论，CA153与KL-6呈正相关，可能是预测RA患者ILD诊断和严重程度的一种重要且临床上可有效测量的血清标志物。
