Diagnostic efficacy of serum Krebs von den Lungen-6 for dermatomyositis/polymyositis-associated interstitial lung diseases: A systematic review and meta-analysis

血清克雷布斯肺6抗体对皮肌炎/多发性肌炎相关间质性肺疾病的诊断效能:系统评价和荟萃分析

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Abstract

BACKGROUND: Previous studies have reported inconsistent findings regarding the diagnostic role of Krebs Von den Lungen-6 (KL-6) in dermatomyositis/polymyositis-associated interstitial lung disease (PM/DM-ILD) and its correlation with disease severity. This meta-analysis aimed to evaluate the diagnostic efficacy of serum KL-6 in detecting DM/PM-ILD and its association with pulmonary function. METHODS: In April 2023, we systematically searched PubMed, Web of Science, Cochrane Library, CNKI, Wan Fang, and VIP databases to identify studies investigating the association of KL-6 with DM/PM-ILD. Two authors independently screened the literature and assessed the risk of bias for included studies. Data synthesis and analysis were performed using SPSS 20.0 (Chicago), Excel, and Stata 15.0 software, with effect sizes calculated using standard mean differences and 95% confidence intervals (CIs). Diagnostic accuracy was assessed using sensitivity, specificity, and summary receiver operating characteristic curve analysis. This meta-analysis was registered in INPLASY. https://inplasy.com/inplasy-2022-6-0106/. RESULTS: Of the 334 studies retrieved, 9 were included in this meta-analysis. The analysis showed that serum KL-6 levels were significantly higher in DM/PM patients with ILD compared to those without ILD (WMD = 757.15, 95% CI: 558.88-885.41, P <.05). Serum KL-6 demonstrated a sensitivity of 0.82 (95% CI: 0.73-0.89), specificity of 0.90 (95% CI: 0.77-0.96), and an area under the combined summary receiver operating characteristic curve of 0.91 (95% CI: 0.89-0.94). Correlation analyses revealed significant associations between KL-6 levels and various pulmonary function parameters (all P <.05). CONCLUSION: Serum KL-6 shows promise as a diagnostic marker for DM/PM-ILD and is closely associated with disease severity.

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