The Application Of Combine Serum Markers In The Diagnosis Of Interstitial Lung Disease

Objective:The clinical data and serum markers(KL-6,SP-A,SP-D,EGF,VEGF,CCL-18 and CXCL-13)in patients with pulmonary fibrosis were analyzed to explore the role of serum markers in patients with pulmonary fibrosis Early diagnosis and disease progression,prognosis and prognostic value.Methods:1?The clinical data of patients in respiratory department of Second Hospital of Jilin University from June 2015 to 2017 06 were collected,including 51 cases of pulmonary fibrosis,10 cases of healthy control group,6 cases of bronchial asthma group,6 cases of chronic obstructive pulmonary disease 6 cases of disease group,6cases of smoking group.The clinical data of the patients were reviewed and analyzed in order to understand the clinical features of the patients.2?Serum 5ml of fasting venous blood was collected from the above groups of patients and the serum was separated.The expression of CXCL-13,VEGF,CCL-18,EGF,SP-A,SP-D and KL-6 in serum was detected by ELISA.The differences of serum markers in each group were analyzed,and the sensitivity and specificity of each serum markers were compared.Results:1.Analysis of the clinical dataThere are no significant differences were observed between groups in gender distribution(P=0.987 > 0.05),and smoking was statistically significant(P < 0.01),the age distribution in the COPD group and smoking group was statistically significant(P=0.036 < 0.05),no significant difference among other groups(P > 0.05).2.The level of serum expression of each marker(1)Compared with the healthy control group,the levels of serum KL-6,SP-A,SP-D,EGF,VEGF,CCL18,and CXCL13 in the IPF group were significantly higher than those in the healthy control group.(2)Compared with IPF group,the serum markers were different in Asthma group,COPD group and Cigarette group.In addition to CCL18,the other serum markers were lower than IPF group.3.IPF patients serum marker expression levels(1)From the ROC curve,we can see that in all biological indicators of IPF patients,the sensitivity EGF > CXCL-13=KL-6 > SP-D > SP-A=VEGF=CCL18,the specificity CXCL-13 > KL-6 > SP-D > CCL18 > EGF > SP-D.(2)The AUC value of the combined index is significantly greater than the AUC value of a single serum marker.When the 7 markers are combined,the AUC value measured is the largest,and the difference in the AUC value between the combined marker and each single marker is statistically significant(P<0.01).4.The expression level of each serum marker is different in different types of interstitial lung diseases.Conclusions:1.The levels of serum KL-6,SP-A,SP-D,EGF,VEGF,CCL-18,and CXCL-13 were significantly higher in the IPF group than in the healthy control group;2.Different markers were not uniformly expressed in serum of patients with different ILDs;3.7 serum markers have certain significance in the differential diagnosis of IPF,and have important value in assessing the severity of the disease and predicting the disease progression;4.The combined serum markers have higher sensitivity and specificity in the diagnosis of IPF than single markers,and are more cost-effective for the management of patients with ILDs.