title: Prognostic value of serial serum KL-6 measurements in patients with idiopathic pulmonary fibrosis.
abstract: BACKGROUND
  The prognostic significance of serial measurements of serum KL-6 levels in patients with idiopathic pulmonary fibrosis (IPF) is unclear; hence, it was assessed in this study.
  
  
  METHODS
  Medical records of 66 patients with IPF, who were not treated with pirfenidone prior to enrollment, were retrospectively reviewed for information on clinical progress, forced vital capacity (FVC), survival, and serum KL-6 levels. We assessed initial serum levels of KL-6, serial changes in serum KL-6 levels, yearly decline in FVC (ΔFVC), and the rate of decline (%ΔFVC).
  
  
  RESULTS
  Patients with increased serum KL-6 levels during follow-up had a significantly steeper decline in ΔFVC than those with no KL-6 increase (-201 vs. -50.7ml/year; p=0.0001). Patients with both initial serum KL-6 ≥1000U/ml and serial increases in serum KL-6 had the steepest decline, while those with both initial serum KL-6 <1000ml and no serial increases in KL-6 had the least decline in ΔFVC and %ΔFVC. Relative to the non-increased KL-6 group, survival in the increased KL-6 group tended to be poorer (p=0.0530). Patients with both initial serum KL-6 values <1000U/ml and no serial increase in KL-6 had more favorable prognoses than those with serial increases in KL-6 or initial serum KL-6 values ≥1000U/ml (p<0.0044). Prognosis was significantly poorer in patients with serial KL-6 changes >51.8U/ml/year than in those with serial KL-6 changes <51.8U/ml/year (p=0.0009).
  
  
  CONCLUSIONS
  Thus, serial serum KL-6 measurements can be useful for assessing prognosis in patients with IPF.
authors.affiliation: Department of Respiratory Medicine, National Hospital Organization Omuta Hospital, Oaza, Tachibana, Omuta City 837-0911, Fukuoka Prefecture, Japan. Electronic address: wakamatsu-k@oomuta-h.com.
authors.forename: Kentaro
authors.initials: K
authors.lastname: Wakamatsu
authors.affiliation: Department of Respiratory Medicine, Fukuoka University Chikushi Hospital, Japan.
authors.forename: Nobuhiko
authors.initials: N
authors.lastname: Nagata
authors.affiliation: Department of Respiratory Medicine, National Hospital Organization Omuta Hospital, Oaza, Tachibana, Omuta City 837-0911, Fukuoka Prefecture, Japan.
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Kumazoe
authors.affiliation: Department of Respiratory Disease, University of Occupational and Environmental Health, Japan.
authors.forename: Keishi
authors.initials: K
authors.lastname: Oda
authors.affiliation: Department of Respiratory Disease, University of Occupational and Environmental Health, Japan.
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Ishimoto
authors.affiliation: Department of Respiratory Disease, National Hospital Organization Fukuoka-Higashi Medical Center, Japan.
authors.forename: Michihiro
authors.initials: M
authors.lastname: Yoshimi
authors.affiliation: Department of Respiratory Disease, National Hospital Organization Fukuoka-Higashi Medical Center, Japan.
authors.forename: Shohei
authors.initials: S
authors.lastname: Takata
authors.affiliation: Department of Respiratory Medicine, National Hospital Organization Minami Kyushu Hospital, Japan.
authors.forename: Minako
authors.initials: M
authors.lastname: Hamada
authors.affiliation: Department of Respiratory Medicine, National Hospital Organization Minami Kyushu Hospital, Japan.
authors.forename: Yoshifusa
authors.initials: Y
authors.lastname: Koreeda
authors.affiliation: Department of Respiratory Medicine, National Hospital Organization Omuta Hospital, Oaza, Tachibana, Omuta City 837-0911, Fukuoka Prefecture, Japan.
authors.forename: Kouji
authors.initials: K
authors.lastname: Takakura
authors.affiliation: Department of Respiratory Medicine, National Hospital Organization Omuta Hospital, Oaza, Tachibana, Omuta City 837-0911, Fukuoka Prefecture, Japan.
authors.forename: Miwa
authors.initials: M
authors.lastname: Ishizu
authors.affiliation: Department of Respiratory Medicine, National Hospital Organization Omuta Hospital, Oaza, Tachibana, Omuta City 837-0911, Fukuoka Prefecture, Japan.
authors.forename: Makiko
authors.initials: M
authors.lastname: Hara
authors.affiliation: Department of Respiratory Medicine, National Hospital Organization Omuta Hospital, Oaza, Tachibana, Omuta City 837-0911, Fukuoka Prefecture, Japan.
authors.forename: Shinji
authors.initials: S
authors.lastname: Ise
authors.affiliation: Department of Respiratory Medicine, National Hospital Organization Omuta Hospital, Oaza, Tachibana, Omuta City 837-0911, Fukuoka Prefecture, Japan.
authors.forename: Miiru
authors.initials: M
authors.lastname: Izumi
authors.affiliation: Department of Respiratory Medicine, National Hospital Organization Omuta Hospital, Oaza, Tachibana, Omuta City 837-0911, Fukuoka Prefecture, Japan.
authors.forename: Takashi
authors.initials: T
authors.lastname: Akasaki
authors.affiliation: Department of Respiratory Medicine, National Hospital Organization Omuta Hospital, Oaza, Tachibana, Omuta City 837-0911, Fukuoka Prefecture, Japan.
authors.forename: Sanae
authors.initials: S
authors.lastname: Maki
authors.affiliation: Department of Respiratory Medicine, National Hospital Organization Minami Kyushu Hospital, Japan.
authors.forename: Masaharu
authors.initials: M
authors.lastname: Kawabata
authors.affiliation: Department of Respiratory Disease, University of Occupational and Environmental Health, Japan.
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Mukae
authors.affiliation: Department of Respiratory Medicine, National Hospital Organization Omuta Hospital, Oaza, Tachibana, Omuta City 837-0911, Fukuoka Prefecture, Japan.
authors.forename: Masayuki
authors.initials: M
authors.lastname: Kawasaki
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D015415:Biomarkers / Q000097:blood; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D054990:Idiopathic Pulmonary Fibrosis / Q000175:diagnosis* / Q000188:drug therapy; D008297:Male; D008875:Middle Aged; D018396:Mucin-1 / Q000097:blood*; D011379:Prognosis; D011728:Pyridones / Q000627:therapeutic use; D012189:Retrospective Studies
chemical_list: D015415:Biomarkers; C060192:MUC1 protein, human; D018396:Mucin-1; D011728:Pyridones; C093844:pirfenidone
keywords: Forced vital capacity; Idiopathic pulmonary fibrosis; Prognosis; Serum KL-6 levels