Changes and significance of serum YKL-40 and CCL18 levels in patients with CTD-ILD

doi:10.11958/20220567

Abstract

Abstract:

Objective To explore the expression and clinical significance of serum levels of YKL-40 and CCL18 in patients with connective tissue disease-associated interstitial lung disease (CTD-ILD). Methods A total of 105 CTD patients including 37 patients with ILD (the CTD-ILD group), 68 patients without ILD (the CTD group) were enrolled into the study. Thirty healthy people were selected as the control group. Clinical data and the test of high resolution CT (HRCT) were detected in the three groups. The serum levels of YKL-40 and CCL18 were detected by ELISA in the three groups. The correlation between lung HRCT score and YKL-40, CCL18 were analyzed. Results The serum levels of YKL-40, CCL18 and CEA were significantly higher in the CTD-ILD group than those in the CTD group. Comparing with the control group, the serum level of YKL-40 was significantly higher in the CTD-ILD group and the CTD group, and the serum level of CCL18 was significantly higher in the CTD-ILD group (P<0.05). Multivariate Logistic regression analysis showed that higher YKL-40 and CCL18 levels were independent risk factors of ILD in CTD patients (P<0.05). ROC curve analysis showed that areas under the curve (AUC) of serum YKL-40 and CCL18 in the diagnosis of CTD-ILD were 0.648 and 0.621, respectively, while AUC of combined diagnosis of CTD-ILD were 0.663 and their sensitivity were higher than those of YKL-40 and CCL18 alone. Correlation analysis showed that levels of YKL-40 and CCL18 were positively correlated with HRCT scores of the CTD-ILD group (respectively r=0.697 and 0.472, both P<0.05). Conclusion The high serum YKL-40 and CCL18 are highly expressed in CTD-ILD patients, and which are independent risk factors of ILD. The combined detection of serum YKL-40 and CCL18 is helpful for the early diagnosis and severity evaluation of CTD-ILD.

Key words: connective tissue diseases, lung diseases, interstitial, chitinase protein 40, chemokine ligand 18, high resolution CT

CLC Number:

R563，R593.2

Figures/Tables 7

References 22

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组别	n	年龄（岁，$\bar{x}±s$）	性别（男/女）	病程（年，$\bar{x}±s$）
对照组	35	52.41±11.03	9/26	-
CTD组	68	54.32±12.78	13/55	5.75±2.39
CTD-ILD组	37	56.51±10.93	8/29	5.64±3.15
F、χ²或t		3.345	2.487	0.278

组别	n	年龄（岁，$\bar{x}±s$）	性别（男/女）	病程（年，$\bar{x}±s$）
对照组	35	52.41±11.03	9/26	-
CTD组	68	54.32±12.78	13/55	5.75±2.39
CTD-ILD组	37	56.51±10.93	8/29	5.64±3.15
F、χ²或t		3.345	2.487	0.278

组别		n	SLE		RA		MCTD
CTD组		68	18（26.83）		15（21.95）		13（19.51）
CTD-ILD组		37	11（29.73）		9（24.32）		7（18.92）
χ²			0.081		0.062		0.004
组别	SSc			SS		SV		PM/DM
CTD组	4（5.88）			10（14.63）		5（7.31）		3（4.88）
CTD-ILD组	6（16.22）			2（5.41）		1（2.71）		1（2.71）
χ²	2.716			1.800		0.851		0.249

组别		n	SLE		RA		MCTD
CTD组		68	18（26.83）		15（21.95）		13（19.51）
CTD-ILD组		37	11（29.73）		9（24.32）		7（18.92）
χ²			0.081		0.062		0.004
组别	SSc			SS		SV		PM/DM
CTD组	4（5.88）			10（14.63）		5（7.31）		3（4.88）
CTD-ILD组	6（16.22）			2（5.41）		1（2.71）		1（2.71）
χ²	2.716			1.800		0.851		0.249

组别	n		YKL-40
对照组	35		992.11（684.11，1 393.47）
CTD组	68		1 834.90（983.04，4 305.33）^a
CTD-ILD组	37		3 858.19（1 440.77，4 863.02）^ab
χ²			12.588^＊＊
组别		CCL18
对照组		393.66（237.51，853.14）
CTD组		618.50（310.84，831.78）
CTD-ILD组		762.55（452.49，1 193.57）^ab
χ²		6.352^＊