IL-27、KL-6在诊断CTD-ILD中的价值

Value of interleukin-27 and Krebs von den lungen-6 in diagnosis of connective tissue disease-associated interstitial lung disease

目的通过分析血清白细胞介素27(IL-27)、涎液化糖链抗原(KL-6)在结缔组织病相关性间质性肺疾病(CTD-ILD)患者中的表达水平,探索它们在诊断CTD-ILD中的价值。方法本试验为前瞻性研究,收集了昆明医科大学第二附属医院26例CTD-ILD患者、33例结缔组织病(CTD)患者及16名同期昆明医科大学第二附属医院体检中心健康成人无吸烟史、无间质性肺疾病、CTD病史及家族史者(正常对照组)的临床资料,对入组对象的血清IL-27、KL-6水平进行检测并分析。结果CTD-ILD组患者的血清IL-27、KL-6水平均显著高于CTD组及正常对照组(P值均<0.05),CTD组的血清KL-6水平明显高于正常对照组(P<0.05),而2组间的血清IL-27水平差异无统计学意义。IL-27、KL-6诊断CTD-ILD的受试者工作特征曲线中,二者的曲线下面积分别为0.659、0.664,诊断临界值分别为50.86 ng/L、4.26μg/L,此时IL-27诊断CTD-ILD的敏感度为53.85%,特异度为69.70%,阳性预测值为58.33%,阴性预测值为65.71%;KL-6诊断CTD-ILD的敏感度为61.54%,特异度为69.70%,阳性预测值为61.54%,阴性预测值为69.70%,二者联合时虽然敏感度降低(34.62%),但特异度明显升高(90.91%)。结论血清IL-27、KL-6单独诊断CTD-ILD准确性较低,二者联合检测在诊断CTD-ILD上可能有一定价值。

Objective To explored the value of interleukin-27(IL-27)and Krebs von den lungen-6(KL-6)in the diagnosis of connective tissue disease-associated interstitial lung disease(CTD-ILD)by analyzing the expressions of serum IL-27 and KL-6 in patients with CTD-ILD.Methods The subjects included 26 patients with CTD-ILD,33 patients with connective tissue disease(CTD),16 healthy adults without smoking history,history of interstitial lung disease and CTD,family history,who were examined in the physical examination center of the Second Affiliated Hospital of Kunming Medical University during the same period.The clinical data of the enrolled subjects were prospectively collected and their serum IL-27 and KL-6 levels were tested.Results The serum levels of IL-27 and KL-6 in the CTD-ILD group were significantly higher than those in the CTD group and the normal group(all P<0.05).The serum KL-6 level in the CTD group was significantly higher than that in the normal group(P<0.05),but there was no significant difference in serum IL-27 level between the two groups.In the receiver operating characteristic curve of IL-27 and KL-6 for diagnosis of CTD-ILD,the areas under curve were 0.659 and 0.664,the cut-off value were 50.86 ng/L and 4.26 mg/L,respectively.At this critical value,the sensitivity of IL-27 to diagnose CTD-ILD was 53.85%,the specificity was 69.70%,the positive predictive value was 58.33%,and the negative predictive value was 65.71%.The sensitivity of KL-6 to diagnose CTD-ILD was 61.54%,the specificity was 69.70%,the positive predictive value was 61.54%,and the negative predictive value was 69.70%.Although the sensitivity of the two indicators combination was reduced(34.62%),the specificity was significantly increased(90.91%).Conclusions The diagnostic accuracy of serum IL-27 and KL-6 for CTD-ILD alone is low,but the combined detection of the two indicators may have certain value in the diagnosis of CTD-ILD.