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The Diagnostic Value of the Interstitial Biomarkers KL-6 and SP-D for the Degree of Fibrosis in Combined Pulmonary Fibrosis and Emphysema.

Chiba S, Ohta H, Abe K, Hisata S, Ohkouchi S, Hoshikawa Y, Kondo T, Ebina M - Pulm Med (2012)

Bottom Line: The combined pulmonary fibrosis and emphysema (CPFE) was reported first in 1990, but it has been comparatively underestimated until recently.We recruited 46 patients who had been diagnosed in our hospital with both emphysema and fibrosis by their CT scan image from April 2003 to March 2008.Interestingly, the combined product of KL-6 and SP-D (KL-6xSP-D) was found to highly correlate with %VC and %TLC or CPI.

View Article: PubMed Central - PubMed

Affiliation: Department of Pulmonary Medicine, Tohoku University Graduate School of Medicine, Sendai 980-8575, Japan.

ABSTRACT
The combined pulmonary fibrosis and emphysema (CPFE) was reported first in 1990, but it has been comparatively underestimated until recently. Although the diagnostic findings of both emphysematous and fibrotic regions are detectable by high-resolution computed tomography (HRCT) of the chest, the degree of progressive fibrosis, which increases with emphysematous lesions, is difficult to evaluate. In this study, we hypothesized that the biomarkers for pulmonary fibrosis, surfactant protein D (SP-D), and KL-6 would serve as good indicators of fibrotic lesions in CPFE. We recruited 46 patients who had been diagnosed in our hospital with both emphysema and fibrosis by their CT scan image from April 2003 to March 2008. The correlation among their pulmonary function tests, composite physiologic index (CPI), and the serum levels of SP-D and KL-6 was evaluated. We found a correlation between KL-6 and %VC, %TLC, or CPI and between SP-D and %VC or CPI. Interestingly, the combined product of KL-6 and SP-D (KL-6xSP-D) was found to highly correlate with %VC and %TLC or CPI. These results show that both KL-6 and SP-D, and especially the product of SP-D and KL-6, are good indicators of the presence of fibrotic lesions in the lungs of CPFE patients.

No MeSH data available.


Related in: MedlinePlus

Imaging from a 64-year-old man with CPFE. (a) HRCT of bilateral upper lung fields shows emphysema. (b) HRCT of bilateral lower lung fields shows traction bronchiectasis and honeycomb and reticular opacities.
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fig1: Imaging from a 64-year-old man with CPFE. (a) HRCT of bilateral upper lung fields shows emphysema. (b) HRCT of bilateral lower lung fields shows traction bronchiectasis and honeycomb and reticular opacities.

Mentions: The diagnosis of CPFE was determined by HRCT scan which indicated the chief distribution of emphysema in the upper zones and pulmonary fibrosis in the lower zones of lungs. The prevalence of honeycombing, ground-glass opacities, and reticular opacities was particularly high. Typical HRCT scan images of these CPFE patients are shown in Figure 1.


The Diagnostic Value of the Interstitial Biomarkers KL-6 and SP-D for the Degree of Fibrosis in Combined Pulmonary Fibrosis and Emphysema.

Chiba S, Ohta H, Abe K, Hisata S, Ohkouchi S, Hoshikawa Y, Kondo T, Ebina M - Pulm Med (2012)

Imaging from a 64-year-old man with CPFE. (a) HRCT of bilateral upper lung fields shows emphysema. (b) HRCT of bilateral lower lung fields shows traction bronchiectasis and honeycomb and reticular opacities.
© Copyright Policy - open-access
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC3316999&req=5

fig1: Imaging from a 64-year-old man with CPFE. (a) HRCT of bilateral upper lung fields shows emphysema. (b) HRCT of bilateral lower lung fields shows traction bronchiectasis and honeycomb and reticular opacities.
Mentions: The diagnosis of CPFE was determined by HRCT scan which indicated the chief distribution of emphysema in the upper zones and pulmonary fibrosis in the lower zones of lungs. The prevalence of honeycombing, ground-glass opacities, and reticular opacities was particularly high. Typical HRCT scan images of these CPFE patients are shown in Figure 1.

Bottom Line: The combined pulmonary fibrosis and emphysema (CPFE) was reported first in 1990, but it has been comparatively underestimated until recently.We recruited 46 patients who had been diagnosed in our hospital with both emphysema and fibrosis by their CT scan image from April 2003 to March 2008.Interestingly, the combined product of KL-6 and SP-D (KL-6xSP-D) was found to highly correlate with %VC and %TLC or CPI.

View Article: PubMed Central - PubMed

Affiliation: Department of Pulmonary Medicine, Tohoku University Graduate School of Medicine, Sendai 980-8575, Japan.

ABSTRACT
The combined pulmonary fibrosis and emphysema (CPFE) was reported first in 1990, but it has been comparatively underestimated until recently. Although the diagnostic findings of both emphysematous and fibrotic regions are detectable by high-resolution computed tomography (HRCT) of the chest, the degree of progressive fibrosis, which increases with emphysematous lesions, is difficult to evaluate. In this study, we hypothesized that the biomarkers for pulmonary fibrosis, surfactant protein D (SP-D), and KL-6 would serve as good indicators of fibrotic lesions in CPFE. We recruited 46 patients who had been diagnosed in our hospital with both emphysema and fibrosis by their CT scan image from April 2003 to March 2008. The correlation among their pulmonary function tests, composite physiologic index (CPI), and the serum levels of SP-D and KL-6 was evaluated. We found a correlation between KL-6 and %VC, %TLC, or CPI and between SP-D and %VC or CPI. Interestingly, the combined product of KL-6 and SP-D (KL-6xSP-D) was found to highly correlate with %VC and %TLC or CPI. These results show that both KL-6 and SP-D, and especially the product of SP-D and KL-6, are good indicators of the presence of fibrotic lesions in the lungs of CPFE patients.

No MeSH data available.


Related in: MedlinePlus