CYFRA 21-1, a cytokeratin subunit 19 fragment, in bronchoalveolar lavage fluid from patients with interstitial lung disease.
1. It has been suggested that CYFRA21-1, a cytokeratin subunit 19 fragment, is potentially useful for diagnosis and monitoring of lung carcinoma. However, serum levels of CYFRA21-1 are also increased in a high proportion of patients with interstitial lung disease. In this study we measured CYFRA21-1 levels in bronchoalveolar lavage fluid from 10 normal subjects, 18 patients with idiopathic pulmonary fibrosis and 14 patients with sarcoidosis, and determined whether any relationship exists between CYFRA21-1 levels in bronchoalveolar lavage fluid and clinical parameters. 2. CYFRA21-1 levels in bronchoalveolar lavage fluid were significantly higher in patients with sarcoidosis (mean value 8.3 ng/ml, P < 0.01) and idiopathic pulmonary fibrosis (42.5 ng/ml, P < 0.005) than in normal controls (1.0 ng/ml). Moreover, higher CYFRA21-1 levels in bronchoalveolar lavage fluid were found in sarcoidosis patients in radiological stage 2 or 3 than in those in stage 1. In patients with idiopathic pulmonary fibrosis, there was a significant correlation between CYFRA21-1 levels, and percentage of inflammatory cells in bronchoalveolar lavage fluid (r = 0.56, P < 0.05) and the magnitude of the alveolar--arterial oxygen pressure difference [P(A-a)O2] gradient (r = 0.66, P < 0.01). 3. Serial bronchoalveolar lavage samples were obtained from six patients with clinically active pneumonitis after they had undergone systemic corticosteroid therapy. CYFRA21-1 levels were significantly lower after these patients exhibited clinical improvement (P < 0.05). 4. These findings suggest that the level of CYFRA21-1 in bronchoalveolar lavage fluid is a useful marker for the clinical diagnosis of pneumonitis, and is also adequate for the evaluation of disease activity, especially over the course of treatment.
First Department of Internal Medicine, Osaka City University Medical School, Japan.
H
H
Kanazawa
T
T
Yoshikawa
M
M
Yamada
S
S
Shoji
T
T
Fujii
S
S
Kudoh
K
K
Hirata
J
J
Yoshikawa
D000305:Adrenal Cortex Hormones / Q000627:therapeutic use; D000951:Antigens, Neoplasm / Q000032:analysis; D015415:Biomarkers / Q000032:analysis; D001992:Bronchoalveolar Lavage Fluid / Q000737:chemistry* / Q000276:immunology; D005260:Female; D006801:Humans; D053539:Keratin-19; D007633:Keratins; D017563:Lung Diseases, Interstitial / Q000188:drug therapy / Q000276:immunology / Q000378:metabolism*; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D011658:Pulmonary Fibrosis / Q000276:immunology / Q000378:metabolism; D012507:Sarcoidosis / Q000188:drug therapy / Q000378:metabolism; D018709:Statistics, Nonparametric
D000305:Adrenal Cortex Hormones; D000951:Antigens, Neoplasm; D015415:Biomarkers; D053539:Keratin-19; C102012:antigen CYFRA21.1; D007633:Keratins