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| Content Provider | Springer Nature : BioMed Central |
|---|---|
| Author | Wakamatsu, Kentaro Nagata, Nobuhiko Kumazoe, Hiroyuki Hara, Makiko Asai, Satomi Noda, Naotaka Kiyotani, Ruriko Fukui, Izumi Tatsuta, Miyoko Katahira, Katsuyuki Akasaki, Takashi Maki, Sanae Miyamoto, Kouta Otsuka, Junji Izumi, Miiru Kawasaki, Masayuki Yamada, Hozumi |
| Abstract | Background The serum markers Krebs von den Lungen-6 (KL-6), surfactant protein A (SP-A), and surfactant protein D (SP-D) have been used for the diagnosis, differential diagnosis, and prognosis prediction of interstitial pneumonia. However, the significance of measuring the serum and bronchoalveolar lavage fluid (BALF) KL-6, SP-D, and SP-A levels in predicting the prognosis of chronic fibrosing interstitial pneumonia (CFIP), idiopathic pulmonary fibrosis, and idiopathic nonspecific interstitial pneumonia remains unclear. We aimed to clarify the significance of measuring the serum and BALF KL-6, SP-A, and SP-D levels in predicting the prognosis of patients with CFIP. Methods Among 173 patients who were diagnosed with CFIP between September 2008 and February 2021, 39 who underwent bronchoalveolar lavage were included in this study. Among these, patients experiencing an annual decrease in forced vital capacity (FVC) of ≥10% or those facing challenges in undergoing follow-up pulmonary function tests owing to significant deterioration in pulmonary function were categorized as the rapidly progress group. Conversely, individuals with an annual decrease in the FVC of <10% were classified into the slowly progress group. The serum and BALF KL-6, SP-D, and SP-A levels, as well as BALF/serum SP-D and SP-A ratios were compared between the two groups. Results Among the patients with CFIP, the BALF SP-D level (p=0.0111), BALF SP-A level (p<0.0010), BALF/serum SP-D ratio (p=0.0051), and BALF/serum SP-A ratio (p<0.0010) were significantly lower in the rapidly than in the slowly progress group (p<0.0010). The receiver operating characteristics analysis results demonstrated excellent performance for diagnosing patients with CFIP, with the BALF SP-D level (area under the curve [AUC], 0.7424), BALF SP-A level (AUC, 0.8842), BALF/serum SP-D ratio (AUC, 0.7673), and BALF/serum SP-A ratio (AUC, 0.8556). Moreover, the BALF SP-A level showed a notably superior CFIP diagnostic capability. Survival analysis using the Kaplan–Meier method revealed that patients with a BALF SP-A level of <1500 ng/mL and BALF/serum SP-A ratio of <15.0 had poor prognoses. Conclusions Our results suggest that BALF SP-A measurement may be useful for predicting the prognosis in patients with CFIP. |
| Related Links | https://bmcpulmmed.biomedcentral.com/counter/pdf/10.1186/s12890-024-03224-1.pdf |
| Ending Page | 10 |
| Page Count | 10 |
| Starting Page | 1 |
| File Format | HTM / HTML |
| ISSN | 14712466 |
| DOI | 10.1186/s12890-024-03224-1 |
| Journal | BMC Pulmonary Medicine |
| Issue Number | 1 |
| Volume Number | 24 |
| Language | English |
| Publisher | BioMed Central |
| Publisher Date | 2024-08-22 |
| Access Restriction | Open |
| Subject Keyword | Pneumology Respiratory System Internal Medicine Intensive Critical Care Medicine Bronchoalveolar lavage fluid Chronic fibrosing interstitial pneumonia Prognosis Surfactant protein A Surfactant protein D Pneumology/Respiratory System |
| Content Type | Text |
| Resource Type | Article |
| Subject | Pulmonary and Respiratory Medicine |
| Journal Impact Factor | 2.6/2023 |
| 5-Year Journal Impact Factor | 3/2023 |
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