Human epididymis protein 4 is a new biomarker to predict the prognosis of progressive fibrosing interstitial lung disease

人类附睾蛋白 4 是预测进行性纤维化间质性肺病预后的新生物标志物

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作者:Naoki Nishiyama, Masahiro Masuo, Yoshihisa Nukui, Tomoya Tateishi, Mitsuhiro Kishino, Ukihide Tateishi, Kaori Morota, Kazuyuki Ohbo, Yasunari Miyazaki

Background

The clinical course and prognosis of progressive fibrosing interstitial lung diseases (PF-ILDs) vary between individuals. Notably, predictive serum biomarkers for disease management are needed. Serum human epididymis protein 4 (HE4) is reportedly elevated in patients with idiopathic pulmonary fibrosis (IPF); however, its clinical utility remains unknown. We evaluated the potential of serum HE4 as a biomarker for patients with PF-ILD.

Conclusions

Serum HE4 levels may serve as a new diagnostic and prognostic biomarker for patients with PF-ILD.

Methods

Serum HE4 was measured in a retrospective study consisting of 34 patients with PF-ILD and 40 healthy volunteers. The relationship between serum HE4 levels and clinical parameters or prognosis was investigated. To validate the significance of

Results

Serum HE4 levels were higher in patients with PF-ILD than in healthy volunteers (P < 0.01). Moreover, serum HE4 levels correlated with the extent of honeycombing on chest high-resolution computed tomography (r = 0.41, P = 0.015). In multivariate analysis using the Cox proportional hazard model, higher HE4 levels (>238 pmol/L) were associated with an elevated mortality risk; hazard ratio (HR) 7.27, 95% CI 1.56-34.0, P = 0.01 in the derivation cohort; HR 44.3, 95% CI 4.19-468, P < 0.01 in validation cohort. Conclusions: Serum HE4 levels may serve as a new diagnostic and prognostic biomarker for patients with PF-ILD.

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