{"title":"诱导痰KL-6联合HRCT评分诊断和监测特发性肺纤维化。","authors":"Bingxin Zhang, Dejun Zhao, Danping Hu","doi":"10.17305/bb.2025.12667","DOIUrl":null,"url":null,"abstract":"<p><p>Idiopathic pulmonary fibrosis (IPF) is a progressive and fatal interstitial lung disease for which reliable early diagnostic biomarkers are still lacking. This study aimed to evaluate the diagnostic and monitoring value of induced sputum Krebs von den Lungen-6 (KL-6) levels in patients with IPF and to investigate their relationship with pulmonary function parameters and high-resolution computed tomography (HRCT) scoring. In this prospective observational study, 20 patients with IPF and 20 age-matched healthy subjects (HS) were enrolled between October 2021 and April 2023. Induced sputum samples were collected for KL-6 measurement using enzyme-linked immunosorbent assay, while all participants underwent pulmonary function testing and HRCT scoring. KL-6 levels were significantly higher in the IPF group compared with the HS group [776.29 (interquartile range, IQR: 681.98-858.57) vs. 322.21 (IQR: 253.67-338.64) U/mL, p<0.001]. In IPF patients, induced sputum KL-6 levels showed strong negative correlations with multiple lung function indices, including forced expiratory volume in one second (FEV1), forced vital capacity (FVC), and diffusing capacity for carbon monoxide (DLCO) (all p<0.05), and a strong positive correlation with HRCT scores (r=0.908, p<0.001). Receiver operating characteristic (ROC) analysis demonstrated that combining KL-6 levels with HRCT scores yielded an area under the curve (AUC) of 0.936 (95% confidence interval, CI: 0.914-0.944), with specificity of 97.5% and sensitivity of 80.0%. In conclusion, induced sputum KL-6 levels reflect the degree of pulmonary fibrosis and are closely associated with functional and imaging indicators in IPF. The combination of KL-6 with HRCT scoring enhances diagnostic accuracy, underscoring its potential clinical utility as a noninvasive biomarker for early detection and monitoring of IPF.</p>","PeriodicalId":72398,"journal":{"name":"Biomolecules & biomedicine","volume":" ","pages":""},"PeriodicalIF":0.0000,"publicationDate":"2025-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Induced sputum KL-6 combined with HRCT scoring for diagnosing and monitoring idiopathic pulmonary fibrosis.\",\"authors\":\"Bingxin Zhang, Dejun Zhao, Danping Hu\",\"doi\":\"10.17305/bb.2025.12667\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><p>Idiopathic pulmonary fibrosis (IPF) is a progressive and fatal interstitial lung disease for which reliable early diagnostic biomarkers are still lacking. This study aimed to evaluate the diagnostic and monitoring value of induced sputum Krebs von den Lungen-6 (KL-6) levels in patients with IPF and to investigate their relationship with pulmonary function parameters and high-resolution computed tomography (HRCT) scoring. In this prospective observational study, 20 patients with IPF and 20 age-matched healthy subjects (HS) were enrolled between October 2021 and April 2023. Induced sputum samples were collected for KL-6 measurement using enzyme-linked immunosorbent assay, while all participants underwent pulmonary function testing and HRCT scoring. KL-6 levels were significantly higher in the IPF group compared with the HS group [776.29 (interquartile range, IQR: 681.98-858.57) vs. 322.21 (IQR: 253.67-338.64) U/mL, p<0.001]. In IPF patients, induced sputum KL-6 levels showed strong negative correlations with multiple lung function indices, including forced expiratory volume in one second (FEV1), forced vital capacity (FVC), and diffusing capacity for carbon monoxide (DLCO) (all p<0.05), and a strong positive correlation with HRCT scores (r=0.908, p<0.001). Receiver operating characteristic (ROC) analysis demonstrated that combining KL-6 levels with HRCT scores yielded an area under the curve (AUC) of 0.936 (95% confidence interval, CI: 0.914-0.944), with specificity of 97.5% and sensitivity of 80.0%. In conclusion, induced sputum KL-6 levels reflect the degree of pulmonary fibrosis and are closely associated with functional and imaging indicators in IPF. The combination of KL-6 with HRCT scoring enhances diagnostic accuracy, underscoring its potential clinical utility as a noninvasive biomarker for early detection and monitoring of IPF.</p>\",\"PeriodicalId\":72398,\"journal\":{\"name\":\"Biomolecules & biomedicine\",\"volume\":\" \",\"pages\":\"\"},\"PeriodicalIF\":0.0000,\"publicationDate\":\"2025-09-12\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Biomolecules & biomedicine\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://doi.org/10.17305/bb.2025.12667\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"0\",\"JCRName\":\"MEDICINE, RESEARCH & EXPERIMENTAL\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Biomolecules & biomedicine","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.17305/bb.2025.12667","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"0","JCRName":"MEDICINE, RESEARCH & EXPERIMENTAL","Score":null,"Total":0}
引用次数: 0
摘要
特发性肺纤维化(IPF)是一种进行性和致死性间质性肺疾病,目前仍缺乏可靠的早期诊断生物标志物。本研究旨在评价诱导痰Krebs von den Lungen-6 (KL-6)水平在IPF患者中的诊断和监测价值,并探讨其与肺功能参数和高分辨率计算机断层扫描(HRCT)评分的关系。在这项前瞻性观察性研究中,在2021年10月至2023年4月期间招募了20名IPF患者和20名年龄匹配的健康受试者(HS)。收集诱导痰样本,采用酶联免疫吸附法测定KL-6,同时对所有参与者进行肺功能检测和HRCT评分。IPF组的KL-6水平显著高于HS组[776.29(四分位数间距,IQR: 681.98 ~ 858.57)比322.21 (IQR: 253.67 ~ 338.64) U/mL, p
Induced sputum KL-6 combined with HRCT scoring for diagnosing and monitoring idiopathic pulmonary fibrosis.
Idiopathic pulmonary fibrosis (IPF) is a progressive and fatal interstitial lung disease for which reliable early diagnostic biomarkers are still lacking. This study aimed to evaluate the diagnostic and monitoring value of induced sputum Krebs von den Lungen-6 (KL-6) levels in patients with IPF and to investigate their relationship with pulmonary function parameters and high-resolution computed tomography (HRCT) scoring. In this prospective observational study, 20 patients with IPF and 20 age-matched healthy subjects (HS) were enrolled between October 2021 and April 2023. Induced sputum samples were collected for KL-6 measurement using enzyme-linked immunosorbent assay, while all participants underwent pulmonary function testing and HRCT scoring. KL-6 levels were significantly higher in the IPF group compared with the HS group [776.29 (interquartile range, IQR: 681.98-858.57) vs. 322.21 (IQR: 253.67-338.64) U/mL, p<0.001]. In IPF patients, induced sputum KL-6 levels showed strong negative correlations with multiple lung function indices, including forced expiratory volume in one second (FEV1), forced vital capacity (FVC), and diffusing capacity for carbon monoxide (DLCO) (all p<0.05), and a strong positive correlation with HRCT scores (r=0.908, p<0.001). Receiver operating characteristic (ROC) analysis demonstrated that combining KL-6 levels with HRCT scores yielded an area under the curve (AUC) of 0.936 (95% confidence interval, CI: 0.914-0.944), with specificity of 97.5% and sensitivity of 80.0%. In conclusion, induced sputum KL-6 levels reflect the degree of pulmonary fibrosis and are closely associated with functional and imaging indicators in IPF. The combination of KL-6 with HRCT scoring enhances diagnostic accuracy, underscoring its potential clinical utility as a noninvasive biomarker for early detection and monitoring of IPF.