Abstract
Background: Asbestosis and silicosis are the progressive pneumoconiosis characterized by interstitial fibrosis as a consequence of exposure to asbestos or silica dust. We aimed to evaluate the potential biomarkers for diagnosing the diseases.
Methods: Serum Krebs von den Lungen (KL)-6, matrix metalloproteinases (MMP)-2,7,9 and surfactant protein (SP)-D were measured in 43 asbestosis, 45 silicosis and 45 healthy controls (HCs). Chest HRCT were reviewed by the experts blinded to clinical data. According to receiver operating characteristic (ROC) curve, the ideal level of each biomarker and the diagnostic sensitivity were obtained.
Results: Serum KL-6 and MMP-2 were highest in asbestosis which was significantly different from those of HCs (P<0.05 respectively). Serum SP-D was significantly increased in asbestosis in comparison to silicosis or HCs (P<0.05 respectively), whereas no statistical difference between silicosis and HCs. No significant difference was found in serum MMP-7 and MMP-9 among asbestosis, silicosis or HCs. Moreover, serum KL-6 was significantly correlated with lung fibrosis scores on HRCT, FVC %pred. and DLCO %pred. (all P<0.05). The order of diagnostic accuracy by ROC curve was KL-6, SP-D and MMP-2 in asbestosis alone or in both. Combination of three biomarkers may enhance the possibility for diagnosis of asbestosis (se 93%, sp 57%) and of asbestosis and silicosis (se 83%, sp 62%).
Conclusions: KL-6, SP-D and MMP-2 were available biomarkers in diagnosing asbestosis as well as silicosis. Combination of KL-6, SP-D and MMP-2 may improve the sensitivity for diagnosis. (National Science and Technology Major Project of China 2014ZX09J15104; National Natural Science Foundation of China 81370159).
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