Comparative accuracy of CA-153 and KL-6 as diagnostic and prognostic biomarkers for interstitial lung disease

IF 3.2 3区医学 Q2 MEDICAL LABORATORY TECHNOLOGY

Clinica Chimica Acta Pub Date : 2024-09-30 DOI:10.1016/j.cca.2024.119980

Chih-Wei Tseng , Kao-Lun Wang , Chung-Yi Li

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引用次数: 0

Abstract

Backgrounds

To discern the potential of KL-6 and CA-153 as diagnostic tools for interstitial lung disease (ILD), understand their relationship with GAP (Gender, Age, and Physiology) stage, and analyze their predictive capacities alongside CT features. This research aims to enhance ILD detection and management in autoimmune patients, emphasizing the diagnostic utility of these biomarkers.

Methods

From Mar 2017 to Mar 2024, 398 patients from Taichung Veterans General Hospital’s Division of Allergy, Immunology, and Rheumatology with autoimmune diseases were prospectively enrolled. ILD diagnoses were confirmed using High-Resolution Computed Tomography (HRCT) or lung biopsy and characterized by radiologists. GAP scores were calculated for IPF prognosis. 583 serum samples were collected and tested for KL-6, CA-153, CA-199, and CA-125 using specific assays. Statistical analyses compared patients, assessed variables, determined missingness, and predicted ILD, with tools like ROC analysis and logistic regressions. Analyses were performed with IBM SPSS and MedCalc.

Results

ILD patients were older, predominantly male, and had more smokers compared to non-ILD. Both KL-6 and CA-153 were higher in ILD and showed a significant, but non-interchangeable correlation. Age, BMI, smoking, and biomarker levels influenced ILD odds, with KL-6 and CA-153 being the strongest predictors. HRCT imaging highlighted these markers’ roles, especially in detecting specific features. Both markers also strongly associated with GAP stages. Stratified analyses emphasized KL-6′s significance in predicting ILD across both AD and non-AD groups. Complete data sensitivity analysis reinforced KL-6 and CA-153 as key ILD predictors.

Conclusions

This research emphasizes CA-153 as a feasible, cost-effective alternative to KL-6 in diagnosing and monitoring ILD. Both CA-153 and KL-6 levels were notably elevated in ILD patients, displaying a strong correlation, especially at CA-153 levels of ≤100 U/ml. They both also have significant associations with CT characteristics and GAP stages. The study reinforces the potential of CA-153, particularly in settings where KL-6 testing might be inaccessible or expensive.

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CA-153 和 KL-6 作为间质性肺病诊断和预后生物标志物的准确性比较。

背景：目的：发现KL-6和CA-153作为间质性肺病（ILD）诊断工具的潜力，了解它们与GAP（性别、年龄和生理）分期的关系，并分析它们与CT特征的预测能力。这项研究旨在加强自身免疫性疾病患者的ILD检测和管理，强调这些生物标志物的诊断效用：2017年3月至2023年3月，台中荣民总医院过敏、免疫与风湿病科的398名自身免疫性疾病患者接受了前瞻性研究。通过高分辨率计算机断层扫描（HRCT）或肺活检确诊 ILD，并由放射科医生进行特征描述。GAP 评分用于计算 IPF 的预后。收集了 583 份血清样本，并使用特定检测方法对 KL-6、CA-153、CA-199 和 CA-125 进行检测。统计分析通过 ROC 分析和逻辑回归等工具对患者进行比较、评估变量、确定缺失率和预测 ILD。分析使用 IBM SPSS 和 MedCalc 进行：结果：与非ILD患者相比，ILD患者年龄较大，以男性为主，吸烟者较多。ILD患者的KL-6和CA-153均较高，并显示出显著但不可互换的相关性。年龄、体重指数（BMI）、吸烟和生物标志物水平影响了ILD的几率，而KL-6和CA-153是最强的预测因子。HRCT 成像突出了这些标志物的作用，尤其是在检测特定特征方面。这两种标志物还与 GAP 分期密切相关。分层分析强调了 KL-6 在预测 AD 组和非 AD 组 ILD 中的重要性。完整的数据敏感性分析加强了KL-6和CA-153作为ILD主要预测指标的作用：这项研究强调，在诊断和监测 ILD 方面，CA-153 是 KL-6 的一种可行且具有成本效益的替代品。ILD患者的CA-153和KL-6水平都明显升高，尤其是当CA-153水平≤100 U/ml时，两者显示出很强的相关性。它们与 CT 特征和 GAP 分期也有明显的相关性。这项研究加强了CA-153的潜力，尤其是在无法进行KL-6检测或检测费用昂贵的情况下。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Clinica Chimica Acta 医学-医学实验技术

CiteScore

10.10

自引率

2.00%

发文量

1268

审稿时长

23 days

期刊介绍： The Official Journal of the International Federation of Clinical Chemistry and Laboratory Medicine (IFCC) Clinica Chimica Acta is a high-quality journal which publishes original Research Communications in the field of clinical chemistry and laboratory medicine, defined as the diagnostic application of chemistry, biochemistry, immunochemistry, biochemical aspects of hematology, toxicology, and molecular biology to the study of human disease in body fluids and cells. The objective of the journal is to publish novel information leading to a better understanding of biological mechanisms of human diseases, their prevention, diagnosis, and patient management. Reports of an applied clinical character are also welcome. Papers concerned with normal metabolic processes or with constituents of normal cells or body fluids, such as reports of experimental or clinical studies in animals, are only considered when they are clearly and directly relevant to human disease. Evaluation of commercial products have a low priority for publication, unless they are novel or represent a technological breakthrough. Studies dealing with effects of drugs and natural products and studies dealing with the redox status in various diseases are not within the journal''s scope. Development and evaluation of novel analytical methodologies where applicable to diagnostic clinical chemistry and laboratory medicine, including point-of-care testing, and topics on laboratory management and informatics will also be considered. Studies focused on emerging diagnostic technologies and (big) data analysis procedures including digitalization, mobile Health, and artificial Intelligence applied to Laboratory Medicine are also of interest.