Significance And Correlation Analysis Of KL-6 And Tumor Markers In The Diagnosis Of Interstitial Lung Disease

BackgroundInterstitial lung disease(ILD)is a kind of chronic diffuse lung disease caused by lung interstitial,alveolar wall and bronchial injury.Foreign reports have shown that the incidence rate of this disease is about(26.1-36.5)/100 thousand,and the incidence rate of environmental exposure has been increasing in recent years.At present,the diagnosis of interstitial lung disease mainly depends on high-resolution CT(HRCT),fiberoptic bronchoscopy,surgical lung biopsy and so on.Although the diagnosis rate of these examinations is high,there are corresponding shortcomings.At present,it is necessary to find the serum biomarkers of ILD in clinic.The detection of these biomarkers is conducive to the early diagnosis,early detection and treatment of ILD,improving the prognosis and prolonging the survival period of patients.ObjectiveTo explore the significance of serum Krebs von den Lungen-6(KL-6)and tumor markers in patients with interstitial lung disease and the correlation with disease by analyzing the levels of KL-6 and tumor markers in patients with various types of ILD,so as to predict the prognosis of the disease.Data and methodsRetrospective analysis of the data of 152 patients diagnosed with ILD who were hospitalized in the First Affiliated Hospital of Zhengzhou University from June 2018 to September 2019(including 66 patients with Idiopathic pulmonary fibrosis(IPF),21 patients with Rheumatoid associated interstitial lung disease(RA-ILD),21 patients with Polymyositis/dermatomyositis associated interstitial lung disease(PM/DM-ILD),15 patients with Sjogren’s syndrome associated interstitial lung disease(SS-ILD),11 patients with Anti neutrophil cytoplasmic antibody associated vasculitis with ILD,5 patients with Systemic lupus erythematosus associated interstitial lung disease(SLE-ILD),2 patients with Systemic sclerosis associated interstitial lung disease(SSc-ILD),1 patient with pneumoconiosis and 10 patients with unclassified interstitial lung disease).And collected 48 patients with other benign lung diseases(other lung diseases group)and 48 healthy people(normal control group,excluding known related diseases)who were matched with gender and age and reached the hospital at the same period.Obtain and record the serum KL-6 and tumor marker levels of the subjects.To compare whether the three groups had statistically significant differences in serum KL-6,tumor markers(carcinoembryonic antigen(CEA),carbohydrate antigen 125(CA125),carbohydrate antigen 199(CA199),Cytokeratin 19 fragment(cyfra211),neuron-specific enolase(NSE))and whether these indicators in the disease group are related to the HRCT Score and lung function.Kruskal Wallis h test was used for the three groups of independent samples,and Bonferroni correction test level α’=0.0167 was used for the comparison between the two groups.Compared with the normal control group,ILD group was tested by Mann Whitney U rank sum test and x2 test,and Spearman was used for correlation analysis.α=0.05 was the test level.Results1.The indexes of KL-6,CEA,CA125,CA199,cyfra211 and NSE in ILD group,other lung disease group and normal control group were statistically analyzed.The results showed that there were differences among the three groups in serum KL-6,CEA,CA125,CA199 and cyfra211(P<0.05),but there was no statistical difference between the three groups in NSE(P>0.05).After a pairwise comparison,the results showed that serum KL-6,CEA,CA125,CA199,CYFRA211 in the ILD group were higher than other lung disease groups and normal control group,the difference was statistically significant(P<0.0167);other lung diseases compared with the normal control group,the results showed that there was no statistical difference in serum KL-6,CEA,CA125,CA199,CYFRA211(P>0.0167);see Table 3.2.Serum levels of KL-6,CEA,CA125,CA199,and CYFRA211 in the IPF group were higher than those in the normal control group,and the difference was statistically significant(P<0.05).The serum levels of KL-6,CEA,CA125,and CA199 in the RA-ILD group were higher than that of the normal control group,and the difference was statistically significant(P<0.05);compared with the normal control group,the serum CYFRA211 level was not statistically significant(P>0.05).PM/DM-ILD patient group analysis showed that the levels of KL-6,CEA and CYFRA211 were higher than the normal control group,the difference was statistically significant(P<0.05);the serum CA125 and CA199 levels were not statistically different from the normal control group(P>0.05).The level of serum KL-6 was higher in the SS-ILD patient group,and the difference was statistically significant(P<0.05);the remaining CEA,CA125,CA199,CYFRA211 and the normal control group had no statistically significant difference(P>0.05).3.For the clinical reference values,the positive rates of KL-6,CEA,CA125,CA199 and cyfra211 in IPF group were higher than those in the normal control group,and the positive rates(95.45%)in IPF group were significantly higher than those in the normal control group(27.08%),the difference was statistically significant(P<0.05),and the specificity was 72.92%.The positive levels of serum KL-6,CEA,CA125,CA199 in the RA-ILD group were higher than the positive rate of the normal control group,4 items were tested together indicators,the positive rate(95.24%)in the RA-ILD group was also significantly higher than that of the control group(22.92%),with a specificity of 72.92%,and the differences were statistically significant(P<0.05).4.In ILD,serum KL-6,CEA,CA125,CA199,CYFRA211 levels were positively correlated with HRCT score(the correlation coefficients were 0.635,0.530,0.543,0.472 and 0.266,respectively,P<0.05);serum KL-6,CEA,CA125,CA199 levels were correlated with carbon monoxide dispersion as a percentage of predicted value(DLCO%)and vital capacity as a percentage of expected value(VC%)has a negative correlation(the correlation coefficients were-0.484,-0.410,-0.389,-0.188,-0.467,-0.357,-0.358 and-0.295,respectively,P<0.05),and serum CYFRA211 levels have no significant correlation with DLCO%and VC%(P>0.05).Conclusion1.Serum KL-6 and tumor markers CEA,CA125,CA199,CYFRA211 can be increased in ILD,and different types of ILD have different levels of tumor markers;their levels may be used as an indicator to assist clinical diagnosis of ILD.2.Reasonable joint detection of serum KL-6 and tumor markers may have high clinical application value in the diagnosis of idiopathic pulmonary fibrosis and rheumatoid arthritis-related interstitial lung disease.3.Serum KL-6 and tumor markers CEA,CA125,CA199 levels may indirectly reflect the severity of interstitial lung disease.