Abstract
ObjectInterstitial lung disease (ILD) is a specific form of chronic fibrosing interstitial pneumonia with various etiology. The severity and progression of ILD usually predict the poor outcomes of ILD. Otherwise, Krebs von den Lungen-6 (KL-6) is a potential immunological biomarker reflecting the severity and progression of ILD. This meta-analysis is to clarify the predictive value of elevated KL-6 levels in ILD.MethodEBSCO, PubMed, and Cochrane were systematically searched for articles exploring the prognosis of ILD published between January 1980 and April 2021. The Weighted Mean Difference (WMD) and 95% Confidence Interval (CI) were computed as the effect sizes for comparisons between groups. For the relationship between adverse outcome and elevated KL-6 concentration, Hazard Ratio (HR), and its 95%CI were used to estimate the risk factor of ILD.ResultOur result showed that ILD patients in severe and progressive groups had higher KL-6 levels, and the KL-6 level of patients in the severe ILD was 703.41 (U/ml) than in mild ILD. The KL-6 level in progressive ILD group was 325.98 (U/ml) higher than that in the non-progressive ILD group. Secondly, the KL-6 level of patients in acute exacerbation (AE) of ILD was 545.44 (U/ml) higher than stable ILD. Lastly, the higher KL-6 level in ILD patients predicted poor outcomes. The KL-6 level in death of ILD was 383.53 (U/ml) higher than in survivors of ILD. The pooled HR (95%CI) about elevated KL-6 level predicting the mortality of ILD was 2.05 (1.50–2.78), and the HR (95%CI) for progression of ILD was 1.98 (1.07–3.67).ConclusionThe elevated KL-6 level indicated more severe, more progressive, and predicted the higher mortality and poor outcomes of ILD.
Highlights
Interstitial lung disease (ILD) is a heterogeneous group of diseases
This study conducts a quantitative comparison of the Kl-6 level of ILD between-groups unprecedentedly, and it resulted in the weighted mean difference (WMD) (95%CI) about Krebs von den Lungen-6 (KL-6) between-groups
We concluded that the elevated KL-6 level could predict the severity, progression, and poor outcomes of ILD
Summary
Interstitial lung disease (ILD) is a heterogeneous group of diseases. Despite various types of clinical presentation, the rapid progression and more severe symptoms of ILD are tending to be fatal. Within the clinical course of ILD, the severity and progression of ILD could occur at any phase closely associated with significant morbidity and mortality [1,2,3]. The global prevalence of ILD is between 10.7 and 27.14 per 100,000 people [4]. In 2013, 595,000 cases a year were diagnosed with ILD worldwide and resulted in 471,000 deaths [5].
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