The Significance of Serum KL-6 Level in the Diagnosis of Rituximab Associated Interstitial Lung Disease
Objective To investigate the diagnostic value of serum Krebs Von den Lungen-6(KL-6)levels in rituximab induced interstitial lung disease(RTX-ILD).Methods 120 patients with non-hodgkin's lymphoma(NHL)treated with rituximab(RTX)chemotherapy in the Respiratory and Critical Care Medicine Department of the Aerospace Center Hospital were selected for the study.Clinical data,including baseline values such as serum KL-6 concentration,were recorded before the first chemotherapy,and serum KL-6 concentration and partial oxygen pressure(PO2)were measured before the fourth chemotherapy;According to whether ILD was present after chemotherapy,these patients were divided into the RTX-ILD group(51 cases)and non-ILD group(69 cases);In addition,the RTX-ILD group was further divided into four levels based on clinical imaging and symptoms.The correlation between serum KL-6 concentration,PO2,and severity of the disease was analyzed.The receiver operating curve(ROC curve)was plotted to calculate the critical value of serum KL-6 concentration for diagnosing RTX-ILD concentration.Results The serum KL-6 concentration in the RTX-ILD group(1201±728U/mL)was significantly higher than that in the non-ILD group(189±110U/mL)(t=7.125,P＜0.05);Before the fourth treatment,the serum KL-6 concentration in the RTX-ILD group was 604±321U/mL,with a statistically significant difference(x2=3.56,P＜0.05);In clinical diagnostic grading,the serum KL-6 concentrations between G1,G2,G3,and G4 groups were statistically significant(X2=4.34,P＜0.05).The correlation analysis results showed a negative correlation between serum KL-6 levels and arterial blood gas analysis results of PO2(r=-0.827,P＜0.05).The critical value for serum KL-6 detection was 520 U/mL.The sensitivity and specificity of RTX-ILD diagnosis were 83.2％(95％CI 70.3％90.1％)and 77.0％(95％CI 73.4％84.3％),respectively.The area under the ROC curve was 0.798.Conclusion Serum KL-6 concentration increases with the increased risk of RTX-ILD in patients receiving RTX chemotherapy for non-hodgkin's lymphoma,and is a potential predictive indicator of RTX-ILD.Determination of serum KL-6 concentration can be beneficial for the diagnosis and evaluation of RTX-ILD.
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