CA 19-9 serum levels in patients with end-stage idiopathic pulmonaryfibrosis (IPF) and other interstitial lung diseases (ILDs): Correlation withfunctional decline

摘要

Idiopathic pulmonary fibrosis presents a progressive and heterogeneous functionaldecline. CA 19-9 has been proposed as biomarker to predict disease course, butits role remains unclear. We assessed CA 19-9 levels and clinical data inend-stage ILD patients (48 IPF and 20 non-IPF ILD) evaluated for lungtransplant, to correlate these levels with functional decline. Patients werecategorized based on their rate of functional decline as slow (n = 20; ΔFVC%pred≤ 10%/year) or rapid progressors (n = 28; ΔFVC%pred ≥ 10%/year). Nearly half ofthe entire patients (n = 32; 47%) had CA 19-9 levels ≥37kU/L. CA 19-9 levels inIPF were not different from non-IPF ILD populations, however, the latter grouphad a median CA 19-9 level above the normal cut-off value of 37 KU/l (60[17–247] kU/L). Among IPF patients, CA 19-9 was higher in slow than in rapidprogressors with a trend toward significance (33vs17kU/L; p = 0.055). In thewhole population, CA19-9 levels were inversely related with ΔFVC/year (r =−0.261; p = 0.03), this correlation remained in IPF patients, particularly inrapid progressors (r = −0.51; p = 0.005), but not in non. Moreover, IPF rapidprogressors with normal CA 19-9 levels showed the greater ΔFVC/year compared tothose with abnormal CA 19-9 (0.95 vs. 0.65 L/year; p = 0.03). In patients withend-stage ILD, CA 19-9 may represent a marker of disease severity, whereas itslevel is inversely correlated with functional decline, particularly among IPFrapid progressors.