Diagnostic Value of Krebs von den Lungen (KL-6) for Interstitial Lung Disease: A European Prospective Cohort
Arch Bronconeumol. 2024 Apr 6:S0300-2896(24)00088-7.
doi: 10.1016/j.arbres.2024.03.028.
Online ahead of print.
[Article in
English,
Spanish]
Affiliations
- 1 Respiratory Medicine Department, Hospital Universitari Germans Trias i Pujol, Badalona, Spain; Respiratory Medicine Department, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain; Sant Pau Biomedical Research Institute (IIB-Sant Pau), Barcelona, Spain; Medicine Department, Universitat Autònoma de Barcelona, Spain.
- 2 Sant Pau Biomedical Research Institute (IIB-Sant Pau), Barcelona, Spain; Medicine Department, Universitat Autònoma de Barcelona, Spain; Rheumatology Department, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain.
- 3 Sant Pau Biomedical Research Institute (IIB-Sant Pau), Barcelona, Spain; Immunology Department, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain; Cellular Biology, Physiology, and Immunology Department, Universitat Autònoma de Barcelona, Spain.
- 4 Respiratory Medicine Department, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain; Cellular Biology, Physiology, and Immunology Department, Universitat Autònoma de Barcelona, Spain; Respiratory Medicine Department, Hospital Universitario Arnau de Vilanova, Lleida, Spain.
- 5 Respiratory Diseases Unit, Department of Medical and Surgical Sciences and Neurosciences, University of Siena, Siena, Italy.
- 6 Radiology Department, Thoracic Unit, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain.
- 7 Respiratory Medicine Department, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain; Sant Pau Biomedical Research Institute (IIB-Sant Pau), Barcelona, Spain; Medicine Department, Universitat Autònoma de Barcelona, Spain. Electronic address: dcastillo@santpau.cat.
Abstract
Introduction:
Krebs von den Lungen 6 (KL-6) is a mucin-1 glycoprotein produced by type II pneumocytes. High levels of KL-6 in blood may be found in patients with lung fibrosis. In Asia this biomarker is used for diagnosis and prognosis in interstitial lung diseases (ILD). There is a lack of information regarding KL-6 cut-off point for diagnosis and prognosis in European population. The aim of this study was to establish the cut-off point for serum KL-6 associated with the presence of ILD in the Spanish population.
Methods:
Prospective study including subjects who underwent chest HRCT, PFTs and autoimmune blood analysis. Two groups were created: non-ILD subjects and ILD patients. Serum KL-6 concentrations were measured using a Lumipulse KL-6 reagent assay and the optimal cut-off value was evaluated by a ROC analysis. Data on demographics and smoking history was also collected.
Results:
One hundred seventy-nine patients were included, 102 with ILD. Median serum KL-6 values overall were 762U/mL, 1080 (±787)U/mL for the ILD group vs 340 (±152)U/mL for the non-ILD group (p<0.0001). The main radiological pattern was NSIP (43%). ROC analysis showed greater specificity (86%) and sensitivity (82%) for KL-6 465U/mL for detecting ILD patients. The multivariate logistic regression model pointed to the male sex, higher KL-6 values, lower FVC and low DLCO values as independent factors associated with ILD.
Conclusion:
Serum KL-6 values greater than 465U/mL have excellent sensitivity and specificity for detecting ILD in our Spanish cohort. Multicentre studies are needed to validate our results.
Keywords:
Interstitial lung disease; KL-6; Krebs von den Lungen; Lung biomarkers; Non-specific interstitial pneumonia; Serum biomarkers.
Copyright © 2024 SEPAR. Published by Elsevier España, S.L.U. All rights reserved.