Serum Krebs von den Lungen-6 level predicts disease progression in interstitial lung disease

• Published in: PloS one 2020-12, Vol.15 (12), p.e0244114-e0244114
• Main Authors: Ko, Ui Won, Cho, Eun Jung, Oh, Heung-Bum, Koo, Hyun Jung, Do, Kyung-Hyun, Song, Jin Woo
• Format: Article
• Language: English
• Subjects: Aged; Biological markers; Biology and Life Sciences; Biomarkers; Biomarkers - blood; Carbon monoxide; Care and treatment; Computed tomography; Connective tissue diseases; Critical care; Development and progression; Disease-Free Survival; Evaluation; Female; Fibrosis; Humans; Idiopathic Pulmonary Fibrosis - blood; Idiopathic Pulmonary Fibrosis - diagnostic imaging; Idiopathic Pulmonary Fibrosis - mortality; Idiopathic Pulmonary Fibrosis - physiopathology; Laboratories; Lung diseases; Lung diseases, Interstitial; Lung Diseases, Interstitial - blood; Lung Diseases, Interstitial - diagnostic imaging; Lung Diseases, Interstitial - mortality; Lung Diseases, Interstitial - physiopathology; Male; Medical prognosis; Medical schools; Medicine; Medicine and Health Sciences; Middle Aged; Mucin-1 - blood; Oxygen; Oxygen content; Patients; Physical Sciences; Pneumonia; Predictive Value of Tests; Prognosis; Pulmonary fibrosis; Research and Analysis Methods; Survival Rate; Testing; Tomography, X-Ray Computed; Tuberculosis; Vital Capacity
• ISSN: 1932-6203; 1932-6203
• DOI: 10.1371/journal.pone.0244114

Disease progression (DP) in interstitial lung disease (ILD) is variable and difficult to predict. In previous reports, serum Krebs von den Lungen-6 (KL-6) was suggested to be useful in diagnosing and predicting survival in ILD. The aim of our study was to investigate the usefulness of serum KL-6 as a predictor of DP in ILD. Clinical data of 199 patients with ILD (idiopathic pulmonary fibrosis: 22.8%) were prospectively collected and serum KL-6 levels were measured. DP was defined as a relative decline in forced vital capacity (FVC) ≥ 10%, acute exacerbation, or death during follow-up. The median follow-up period was 11.1 months. The mean age of the subjects was 62.2 years, and 59.8% were male. DP occurred in 21.6% of patients. The progressed group showed lower FVC, lower diffusing capacity for carbon monoxide, lower the minimum oxygen saturation during the 6-minute walk test, higher fibrosis scores on high-resolution computed tomography, and higher KL-6 levels (826.3 vs. 629.0 U/mL; p < 0.001) than those of the non-progressed group. In receiver operating characteristic curve analysis, serum KL-6 levels were a significant predictor of DP in ILD (area under the curve = 0.629, p = 0.009, and the optimal cut-off level was 811 U/mL). In multivariable Cox analysis, high serum KL-6 levels (≥ 800 U/mL) were only independently associated with DP in ILD (HR 2.689, 95% CI 1.445-5.004, P = 0.002). Serum KL-6 levels might be useful to predict DP in patients with ILD.