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CA 19-9 serum levels in patients with end-stage idiopathic pulmonary fibrosis (IPF) and other interstitial lung diseases (ILDs): Correlation with functional decline.
Chronic Respiratory Disease ( IF 4.1 ) Pub Date : 2020-09-24 , DOI: 10.1177/1479973120958428
Elisabetta Balestro 1 , Gioele Castelli 1 , Nicol Bernardinello 1 , Elisabetta Cocconcelli 1 , Davide Biondini 1 , Federico Fracasso 1 , Federico Rea 1 , Marina Saetta 1 , Simonetta Baraldo 1 , Paolo Spagnolo 1
Affiliation  

Idiopathic pulmonary fibrosis presents a progressive and heterogeneous functional decline. CA 19-9 has been proposed as biomarker to predict disease course, but its role remains unclear. We assessed CA 19-9 levels and clinical data in end-stage ILD patients (48 IPF and 20 non-IPF ILD) evaluated for lung transplant, to correlate these levels with functional decline. Patients were categorized based on their rate of functional decline as slow (n = 20; ΔFVC%pred ≤ 10%/year) or rapid progressors (n = 28; ΔFVC%pred ≥ 10%/year). Nearly half of the entire patients (n = 32; 47%) had CA 19-9 levels ≥37kU/L. CA 19-9 levels in IPF were not different from non-IPF ILD populations, however, the latter group had a median CA 19-9 level above the normal cut-off value of 37 KU/l (60 [17–247] kU/L). Among IPF patients, CA 19-9 was higher in slow than in rapid progressors with a trend toward significance (33vs17kU/L; p = 0.055). In the whole population, CA19-9 levels were inversely related with ΔFVC/year (r = −0.261; p = 0.03), this correlation remained in IPF patients, particularly in rapid progressors (r = −0.51; p = 0.005), but not in non. Moreover, IPF rapid progressors with normal CA 19-9 levels showed the greater ΔFVC/year compared to those with abnormal CA 19-9 (0.95 vs. 0.65 L/year; p = 0.03). In patients with end-stage ILD, CA 19-9 may represent a marker of disease severity, whereas its level is inversely correlated with functional decline, particularly among IPF rapid progressors.



中文翻译:

终末期特发性肺纤维化 (IPF) 和其他间质性肺病 (ILD) 患者的 CA 19-9 血清水平:与功能衰退的相关性。

特发性肺纤维化呈现进行性和异质性功能衰退。CA 19-9 已被提议作为预测病程的生物标志物,但其作用尚不清楚。我们评估了评估肺移植的终末期 ILD 患者(48 名 IPF 和 20 名非 IPF ILD)的 CA 19-9 水平和临床数据,以将这些水平与功能衰退相关联。患者根据其功能衰退率分为缓慢(n = 20;ΔFVC%pred ≤ 10%/年)或快速进展者(n = 28;ΔFVC%pred ≥ 10%/年)。近一半的患者(n = 32;47%)的 CA 19-9 水平≥37kU/L。IPF 中的 CA 19-9 水平与非 IPF ILD 人群没有区别,然而,后一组的 CA 19-9 水平中位数高于正常临界值 37 KU/l (60 [17-247] kU /L)。在 IPF 患者中,CA 19-9 在缓慢进展者中高于快速进展者,并具有显着性趋势(33vs17kU/L;p = 0.055)。在整个人群中,CA19-9 水平与 ΔFVC/年呈负相关(r = -0.261;p = 0.03),这种相关性在 IPF 患者中仍然存在,特别是在快速进展者中(r = -0.51;p = 0.005),但不在非。此外,与 CA 19-9 异常的患者相比,具有正常 CA 19-9 水平的 IPF 快速进展者表现出更大的 ΔFVC/年(0.95 对 0.65 L/年;p = 0.03)。在终末期 ILD 患者中,CA 19-9 可能代表疾病严重程度的标志,而其水平与功能下降呈负相关,尤其是在 IPF 快速进展者中。这种相关性在 IPF 患者中仍然存在,特别是在快速进展者中(r = -0.51;p = 0.005),但在非患者中则不然。此外,与 CA 19-9 异常的患者相比,具有正常 CA 19-9 水平的 IPF 快速进展者表现出更大的 ΔFVC/年(0.95 对 0.65 L/年;p = 0.03)。在终末期 ILD 患者中,CA 19-9 可能代表疾病严重程度的标志物,而其水平与功能下降呈负相关,尤其是在 IPF 快速进展者中。这种相关性在 IPF 患者中仍然存在,特别是在快速进展者中(r = -0.51;p = 0.005),但在非患者中则不然。此外,与 CA 19-9 异常的患者相比,具有正常 CA 19-9 水平的 IPF 快速进展者表现出更大的 ΔFVC/年(0.95 对 0.65 L/年;p = 0.03)。在终末期 ILD 患者中,CA 19-9 可能代表疾病严重程度的标志物,而其水平与功能下降呈负相关,尤其是在 IPF 快速进展者中。

更新日期:2020-09-24
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