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Vol. 60. Issue 6.
Pages 350-355 (June 2024)
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Vol. 60. Issue 6.
Pages 350-355 (June 2024)
Original Article
Diagnostic Value of Krebs von den Lungen (KL-6) for Interstitial Lung Disease: A European Prospective Cohort
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Paloma Millan-Billia,b,c,d, Iván Castellvíc,d,e, Laura Martinez-Martinezc,f,g, Anais Mariscalc,f,g, Silvia Barrilb,g,h, Miriana D’Alessandroi, Tomás Franquetj, Diego Castillob,c,d,
Corresponding author
dcastillo@santpau.cat

Corresponding author.
a Respiratory Medicine Department, Hospital Universitari Germans Trias i Pujol, Badalona, Spain
b Respiratory Medicine Department, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain
c Sant Pau Biomedical Research Institute (IIB-Sant Pau), Barcelona, Spain
d Medicine Department, Universitat Autònoma de Barcelona, Spain
e Rheumatology Department, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain
f Immunology Department, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain
g Cellular Biology, Physiology, and Immunology Department, Universitat Autònoma de Barcelona, Spain
h Respiratory Medicine Department, Hospital Universitario Arnau de Vilanova, Lleida, Spain
i Respiratory Diseases Unit, Department of Medical and Surgical Sciences and Neurosciences, University of Siena, Siena, Italy
j Radiology Department, Thoracic Unit, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain
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Figures (4)
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Tables (3)
Table 1. Patient Demographic, Clinical, and Functional Respiratory Test Characteristics.
Table 2. Patients Characteristics According to FVC <70%.
Table 3. Prognostic Factors for Interstitial Lung Disease.
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Additional material (1)
Abstract
Introduction

Krebs von den Lungen 6 (KL-6) is a mucin-1 glycoprotein produced by type II pneumocytes. High levels of KL-6 in blood may be found in patients with lung fibrosis. In Asia this biomarker is used for diagnosis and prognosis in interstitial lung diseases (ILD). There is a lack of information regarding KL-6 cut-off point for diagnosis and prognosis in European population. The aim of this study was to establish the cut-off point for serum KL-6 associated with the presence of ILD in the Spanish population.

Methods

Prospective study including subjects who underwent chest HRCT, PFTs and autoimmune blood analysis. Two groups were created: non-ILD subjects and ILD patients. Serum KL-6 concentrations were measured using a Lumipulse KL-6 reagent assay and the optimal cut-off value was evaluated by a ROC analysis. Data on demographics and smoking history was also collected.

Results

One hundred seventy-nine patients were included, 102 with ILD. Median serum KL-6 values overall were 762U/mL, 1080 (±787)U/mL for the ILD group vs 340 (±152)U/mL for the non-ILD group (p<0.0001). The main radiological pattern was NSIP (43%). ROC analysis showed greater specificity (86%) and sensitivity (82%) for KL-6 465U/mL for detecting ILD patients. The multivariate logistic regression model pointed to the male sex, higher KL-6 values, lower FVC and low DLCO values as independent factors associated with ILD.

Conclusion

Serum KL-6 values greater than 465U/mL have excellent sensitivity and specificity for detecting ILD in our Spanish cohort. Multicentre studies are needed to validate our results.

Keywords:
Lung biomarkers
Interstitial lung disease
Krebs von den Lungen
KL-6
Serum biomarkers
Non-specific interstitial pneumonia
Abbreviations:
ANA
AUC
CLEIA
CTD
DLCO
ENA
FEV1
FVC
HRCT
ILD
IPF
KL-6
NSIP
PFT
ROC
SD
STROBE
UIP

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