Prognostic value of circulating KL-6 in idiopathic pulmonary fibrosis
Prognostic value of circulating KL-6 in idiopathic pulmonary fibrosis
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DOI：
10.1111/j.1440-1843.2006.00834.x
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发表时间：
2006-03-01
期刊：
影响因子：
6.9
通讯作者：
Kohno, N
中科院分区：
文献类型：
--
作者：
Yokoyama, A;Kondo, K;Kohno, N
目的：KL-6（一种高分子量糖蛋白（MUC 1粘蛋白））的循环水平在大多数患有多种间质性肺病（包括特发性肺纤维化（IPF））的患者中升高。然而，KL-6水平因患者而异。本研究的目的是确定诊断时血清KL-6水平是否可预测IPF的预后。方法：回顾性分析27例IPF患者的临床变量与预后的关系。16例经组织学检查确诊，11例经高分辨率CT扫描确诊。所有患者均随访至少3年。结果：在受试者工作特征曲线确定的临界值下，单因素分析显示LDH、KL-6与患者预后有显著相关性。然而，多因素分析显示，只有KL-6是预后的预测因子。根据血清KL-6水平（高于或低于1000 U/mL的临界水平）对患者进行分类，并使用Kaplan-Meier方法估计其生存期。两组之间的中位生存期差异显著。KL-6水平低的患者中位生存期超过36个月，而KL-6水平高的患者中位生存期仅为18个月。
Objective: Circulating levels of KL-6, a high MW glycoprotein (MUC1 mucin), are elevated in a majority of patients with a number of interstitial lung diseases, including idiopathic pulmonary fibrosis (IPF). However, KL-6 levels vary from patient to patient. The aim of the present study was to determine whether the serum KL-6 level at the time of diagnosis predicts prognosis in IPF.Methods: The relationship between clinical variables and prognosis in 27 patients with IPF were analysed retrospectively. The diagnosis was made by histological examination (n = 16) or on clinical findings including high-resolution CT scanning (n = 11). All patients were followed up for at least 3 years. Variables such as age, FVC%, PaO2 at rest, initial LDH level, C-reactive protein and KL-6 were used for analysis.Results: At the cut-off level determined by receiver operating characteristic curves, LDH and KL-6 showed a significant correlation with the patient's prognosis by univariate analysis. However, multivariate analysis revealed that only KL-6 was a predictor of prognosis. The patients were categorized by their serum KL-6 levels (as above or below the cut-off level of 1000 U/mL) and their survival estimated using the Kaplan-Meier method. The difference in median survival between the two groups was significant. The median survival of patients with low KL-6 was more than 36 months, whereas that of patients with high KL-6 was only 18 months.Conclusion: These results suggest that initial evaluation of serum KL-6 level can predict survival in patients with IPF.