Expression And Significance Of IGF-1 And IGFBP-3 In Bronchoalveolar Lavage Fluid In Patients With Pulmonary Lung Lesions

Objectives:1.To study the expression levels of IGF-1 and IGFBP-3 in BALF of patients with diffuse lesions of lungs.2.To explore the significance of the expression levels of IGF-1 and IGFBP-3 in BALF in the patients in ILD and to evaluate the severity of the disease.Method:A total of 88 patients with diffuse lesions of lungs and bronchoscopy in the second hospital of Hebei Medical University from2018.10 to 2020.10 were selected.ILD group was 62 patients,10 patients in lung cancer group(all confirmed by pathological biopsy of lung tissue),16 patients in pneumonia group(all patients improved imaging after anti-infective treatment).It is further divided into:(1)28 cases in the IIP group:16 cases of IPF,8 cases of of IPAF,and 4 cases of rare IIP;(2)30 cases in the CTD-ILD group: 2 cases of SS-ILD,10 cases of RA-ILD,and 12 cases of PM/DM-ILD,7 cases of UCTD-ILD;(3)Granulomatous ILD group: 2 cases of Sarcoidosis;(4)Other types of ILD group: 2 cases of Pneumoconiosis.The concentrations of IGF-1 and IGFBP-3 in BALF of patients in each group were detected,and the correlation between the expression levels of IGF-1 and IGFBP-3 in BALF of patients in each group and pulmonary function,lung HRCT score,6-minute walking distance,oxygenation index and other indexes was studied,so as to explore the significance of IGF-1 and IGFBP-3 in interstitial lung disease.Results:1.The concentrations of IGF-1 and IGFBP-3 in BALF of IIP and CTD-ILD group were higher than those in pneumonia group and lung cancer group:The difference of IGF-1 in IIP and CTD-ILD group was statistically significant difference compared with that in pneumonia group(P=0.000,P=0.000);The difference of IGF-1 in IIP and CTD-ILD groupwas statistically significant difference compared with that in lung cancer group(P=0.000,P=0.000);The difference of IGFBP-3 in IIP and CTD-ILD group was statistically significant difference compared with that in pneumonia group(P=0.002,P=0.002);The difference of IGFBP-3 in IIP and CTD-ILD group was statistically significant difference compared with that in lung cancer group(P=0.010,P=0.003).2.There was no significant difference in IGF-1 and IGFBP-3concentrations in the BALF of IIP subgroups(P>0.05),and there was no significant difference in IGF-1 and IGFBP-3 concentrations in the BALF of CTD-ILD subgroups(P>0.05).3.Correlation analysis of IGF-1,IGFBP-3 and measured indexes in BALF of IIP group,IPF group and CTD-ILD group:1)In the IIP group,IGF-1 in BALF was negatively correlated with FEV1%pre(r=-0.404,P=0.033),negatively correlated with FVC%pre(r=-0.405,P=0.033),negatively correlated with DLCO%pre(r=-0.375,P=0.049)and positively correlated with lung HRCT score(r=0.734,P=0.000).2)In the IIP group,IGFBP-3 in BALF was negatively correlated with FEV1%pre(r=-0.418,P=0.027),negatively correlated with FVC%pre(r=-0.383,P=0.044)and positively correlated with lung HRCT score(r=0.682,P=0.000).3)In the IPF group,IGF-1 in BALF was negatively correlated with FEV1%pre(r=-0.596,P=0.015),negatively correlated with FVC%pre(r=-0.620,P=0.010),negatively correlated with DLCO%pre(r=-0.649,P=0.007),negatively correlated with oxygenation index(r=-0.556,P=0.025)and positively correlated withlung HRCT score(r=0.654,P=0.006).4)In the IPF group,IGFBP-3 in BALF was negatively correlated with FEV1%pre(r=-0.592,P=0.016),was negatively correlated with FVC%pre(r=-0.563,P=0.023),was negatively correlated with DLCO%pre(r=-0.519,P=0.039)and positively correlated with lung HRCT score(r=0.761,P=0.001).5)In the CTD-ILD group,IGF-1 in BALF was negatively correlated with TLC%pre(r=-0.393,P=0.032),negatively correlated with DLCO%pre(r=-0.511,P=0.004)andpositively correlated with lung HRCT score(r=0.766,P=0.000).6)In the CTD-ILD group,IGFBP-3 in BALF was negatively correlated with DLCO%pre(r=-0.397,P=0.030)and positively correlated with lung HRCT score(r=0.690,P=0.000).Conclusions:1.The expression levels of IGF-1 and IGFBP-3 in bronchoalveolar lavage fluid are significant for the diagnosis of interstitial lung disease.2.IGF-1 and IGFBP-3 levels in bronchoalveolar lavage fluid can assess the severity of interstitial lung disease,and can be used as indicators for disease monitoring in patients with interstitial lung disease.