Application Value Of KL-6 And IL-35 In Alveolar Lavage Fluid In Patients With Diffuse Double Lung Lesions

Objective: To observe the changes of KL-6 and IL-35 in bronchoalveolar lavage fluid(BALF)in patients with diffuse double lung lesions.To study the expression and clinical significance of KL-6 and IL-35 in interstitial lung disease.To investigate the application value of KL-6 and IL-35 in ILD.Method:A total of 94 patients admitted to hospital from October 2017 to October 2019 with imaging findings of bilateral diffuse lung lesions and bronchoscopy were collected.The patients were divided into pneumonia group(18 cases with improved clinical symptoms and imaging),ILD group(60 cases)and lung cancer group(16 cases).The ILD group was divided into IIP group(25 cases): IPF(13 cases),IPF(8 cases),and IIP4(4 cases).There were 30 cases in CTD-ILD group: 5 cases of SS-ILD,8 cases of RA-ILD,10 cases of PM or DM,and 7 cases of undefined type.There were 3 cases of sarcoidosis(confirmed by pathology)in the granulomatous ILD group.Other rare ILD group: pneumoconiosis: 2 cases.The values of KL-6 and IL-35 in BALF of patients in pneumonia group,ILD group and lung cancer group were determined,and the correlation between the changes of KL-6 and IL-35 in patients in each group and lung function indicators,lung CT score,oxygenation index and 6-minute walk was studied,so as to explore the application value of KL-6 and IL-35 in interstitial lung disease.Results:1.The values of KL-6 and IL-35 in BALF of IIP and CTD-ILD group were higher than those of pneumonia group and lung cancer group:The difference of KL-6 in IIP group and CTD-ILD group was statistically significant compared with that in pneumonia group(P = 0.000,P = 0.000);The difference between the IIP group and the pneumonia group was statistically significant(P=0.049);The differences of KL-6 and IL-35 in IIP group,CTD-ILD group and lung cancer group were not statistically significant(P > 0.05).2.Correlation analysis of KL-6 and IL-35 in BALF in CTD-ILD,IIP group and IPF group and the measured indexes:2.1 In CTD-ILD group,KL-6 in BALF was positively correlated with CT score(r=0.515,P=0.004),negatively correlated with oxygenation index(r=-0.365,P=0.047),negatively correlated with FVC%predicted(r=-0.548,P=0.008),negatively correlated with FEV1% predicted(r=-0.433,P=0.044),negatively correlated with TLC%predicted(r=-0.559,P=0.007),negatively correlated with DLco%predicted(r=-0.559,P=0.007).2.2 In CTD-ILD group,IL-35 in BALF was positively correlated with CT score(r=0.476,P=0.008),negatively correlated with FVC%predicted(r=-0.48,P=0.023),negatively correlated with TLC%predicted(r=-0.426,P=0.048),negatively correlated with DLco%predicted(r=-0.459,P=0.032).2.3 In the IIP group,KL-6 in BALF was positively correlated with CT score(r=0.618,P=0.001),negatively correlated with oxygenation index(r=-0.467,P=0.019),negatively correlated with FVC%predicted(r=-0.540,P=0.006),negatively correlated with FEV1% predicted(r=-0.613,P=0.001),negatively correlated with TLC%predicted(r=-0.424,P=0.049),negatively correlated with DLco%predicted(r=-0.608,P=0.003).2.4 In the IIP group,IL-35 in BALF was positively correlated with CT score(r=0.586,P=0.002),negatively correlated with FVC%predicted(r=-0.454,P=0.026),negatively correlated with FEV1% predicted.(r=-0.488,P=0.016),negatively correlated with DLco%predicted(r =-0.488,P= 0.016).2.5 In the IPF group,KL-6 in BALF was positively correlated with CT score(r=0.562,P=0.046),negatively correlated with FVC%predicted(r=-0.611,P= 0.027),negatively correlated with FEV1% predicted(r =-0.623,P=0.023),negatively correlated with DLco%predicted(r=-0.640,P=0.034).2.6 In the IPF group,IL-35 in BALF was positively correlated with CT score(r=0.655,P=0.015),negatively correlated with FVC%predicted(r=-0.602 P=0.029),negatively correlated with FEV1% predicted(r=-0.557,P=0.048),negatively correlated with DLco%predicted(r=-0.671,P=0.024).Conclusions:1.KL-6 and IL-35 in bronchoalveolar lavage solution have certain diagnostic significance for interstitial lung diseases and narrow the differential range.2.The levels of KL-6 and IL-35 in bronchoalveolar lavage solution can reflect the severity of interstitial lung disease.