Serum Krebs von den Lungen-6 concentrations reflect severity of anti-melanoma differentiation-associated protein 5 antibody positive dermatomyositis associated interstitial lung disease.
Serum Krebs von den Lungen-6 concentrations reflect severity of anti-melanoma differentiation-associated protein 5 antibody positive dermatomyositis associated interstitial lung disease.
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DOI：
10.55563/clinexprheumatol/zmn18h
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发表时间：
2021-11
影响因子：
3.7
通讯作者：
Yujing Zhu;Lei Wang;Yuankai Sun;Jiajia Wang;C. Lv;H. You;Lingxiao Xu;Fang Wang;Miaojia Zhang-Mi
中科院分区：
文献类型：
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作者：
Yujing Zhu;Lei Wang;Yuankai Sun;Jiajia Wang;C. Lv;H. You;Lingxiao Xu;Fang Wang;Miaojia Zhang-Mi
快速进展性间质性肺病（RP-ILD）是抗黑色素瘤分化相关蛋白5抗体阳性皮肌炎（抗mda5 +DM）的主要并发症，死亡率高。该研究的目的是确定血清KL-6是否可以作为预测抗mda5 +DM患者RP-ILD和预后的预后生物标志物。方法回顾性分析21例抗mda5 +DM合并RP-ILD患者和20例抗mda5 +DM无RP-ILD患者。用胶乳凝集试验测定血清KL-6浓度（pg/mL）。结果RP-ILD患者血清KL-6水平高于非rr - ild患者（1195.61±872.93∶452.6±465.51 pg/mL, p=0.002）。ROC曲线最佳临界值为500.9 pg/mL （AUC面积= 0.7976,p=0.0011）。多因素分析显示，KL-6 / 500.9 pg/mL是RP-ILD的独立危险因素（OR=56.38, 95% CI 5.51-577.504, p=0.001）。死亡患者血清KL-6浓度显著高于存活组（1209.34±840.55∶592.41±667.76,p=0.0033），调整混杂因素后，较高的KL-6浓度也是全因死亡的独立危险因素（OR = 21.94, 95% CI 3.3 ~ 145.73, p=0.001）。与KL-6水平较低的患者相比，KL-6水平较高的抗mda5 +DM患者的1年生存率显著降低（36.36% vs 89.47%, p=0.0008）。结论血清KL-6水平反映肺损伤的严重程度，可作为检测和监测抗mda5 +DM患者RP-ILD进展的临床有用生物标志物。
OBJECTIVES Rapidly progressive interstitial lung disease (RP-ILD) is a major complication of anti-melanoma differentiation-associated protein 5 antibody positive dermatomyositis (anti-MDA5+DM) with a high mortality rate. Aim of the study is to determine whether serum Krebs von den Lungen-6 (KL-6) could be a prognostic biomarker to predict RP-ILD and prognosis in anti-MDA5+DM patients. METHODS A total of 21 anti-MDA5+DM patients with RP-ILD and 20 anti-MDA5+DM patients without RP-ILD were retrospectively included in this study. Serum KL-6 concentration (pg/mL) was measured using the latex agglutination test. RESULTS Serum KL-6 level was higher in RP-ILD patients than those in non-RR-ILD patients (1195.61±872.93 vs. 452.6±465.51 pg/mL, p=0.002). The best cut-off value of KL-6 serum level was 500.9 pg/mL using ROC curve (AUC area = 0.7976, p=0.0011). KL-6 >500.9 pg/mL was an independent risk factor for RP-ILD using multivariate analysis (OR=56.38, 95% CI 5.51-577.504, p=0.001). Serum KL-6 concentrations were significantly higher in dead patients than those in the survivor group (1209.34±840.55 vs. 592.41±667.76, p=0.0033), and higher KL-6 concentration was also an independent risk factor for all-cause death after adjusting confounders (OR = 21.94, 95% CI 3.3-145.73, p=0.001). Anti-MDA5+DM patients with higher KL-6 level displayed a significantly decreased one-year survival rate, as compared with lower KL-6 level (36.36% vs. 89.47%, p=0.0008). CONCLUSIONS The serum KL-6 levels reflect severity of lung injury and serve as a clinically useful biomarker in detection and monitoring RP-ILD progression in anti-MDA5+DM patients.