Clinical Significance of Serum KL-6 Levels in Organizing Pneumonia Proven by Lung Biopsy

DOI
  • Hara Yu
    Division of Infectious Diseases and Pulmonary Medicine, Department of Internal Medicine, National Defense Medical College:Respiratory Disease Center, Yokohama City University Medical Center
  • Kanoh Soichiro
    Division of Infectious Diseases and Pulmonary Medicine, Department of Internal Medicine, National Defense Medical College
  • Fujikura Yuji
    Division of Infectious Diseases and Pulmonary Medicine, Department of Internal Medicine, National Defense Medical College
  • Kawano Shuichi
    Division of Infectious Diseases and Pulmonary Medicine, Department of Internal Medicine, National Defense Medical College
  • Kozaki Yuji
    Division of Infectious Diseases and Pulmonary Medicine, Department of Internal Medicine, National Defense Medical College
  • Misawa Kazuhisa
    Division of Infectious Diseases and Pulmonary Medicine, Department of Internal Medicine, National Defense Medical College
  • Shinkai Masaharu
    Division of Infectious Diseases and Pulmonary Medicine, Department of Internal Medicine, National Defense Medical College:Respiratory Disease Center, Yokohama City University Medical Center
  • Kawana Akihiko
    Division of Infectious Diseases and Pulmonary Medicine, Department of Internal Medicine, National Defense Medical College

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  • 肺生検にて器質化肺炎所見を認めた症例の血清KL-6の臨床的意義

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Description

Background. Cryptogenic organizing pneumonia (COP) is known to be an interstitial lung disease (ILD) with a good prognosis. The prognosis of secondary organizing pneumonia (SOP) is similar to that of COP. KL-6 is a biomarker that reflects cellular damage and regeneration of type II pneumocytes in ILD patients. It is reported that serum KL-6 is elevated in half of COP patients and is related to the incidence of relapse after treatment. However, there have been no reports about the analysis of the correlation between serum KL-6 levels and clinical features in organizing pneumonia (OP) patients, including both COP and SOP. Methods. To examine clinical characteristics of patients with OP, we analyzed 25 cases of OP diagnosed by lung biopsy from September in 2007 to December in 2013. They were divided into two groups; cases with normal (group A) and elevated level of serum KL-6 (group B). Results. The incidence of dyspnea in group B (n=12) was higher than that in group A (n=13, p<0.001). The pretreatment serum LDH and SP-D levels in group B were higher than those in group A (LDH; p=0.005, SP-D; p=0.005). The pretreatment PaO_2 was lower in group B (p=0.048). Computed tomography showed consolidation as a predominant pattern in group A (p=0.019) and ground glass opacity in the bilateral basal lung in group B (p=0.016). There was no significant difference in the therapeutic regimen, but group B showed more unstable clinical courses than group A (p=0.029). Conclusion. These suggest that OP with elevated serum KL-6 may be more severe and unstable than normal serum KL-6.

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