Chest
Volume 102, Issue 1, July 1992, Pages 117-122
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Circulating Antigen KL-6 and Lactate Dehydrogenase for Monitoring Irradiated Patients with Lung Cancer

https://doi.org/10.1378/chest.102.1.117Get rights and content

To determine the sensitivity of serum KL-6 and serum lactate dehydrogenase for detecting the contraction of radiation pneumonitis, 15 patients with lung cancer who had radiation therapy were monitored. Six of the patients contracted radiation pneumonitis (pneumonitis group) and the other patients did not (control group). Serum levels of KL-6 were significantly (p<0.05) elevated according to the complication of radiation pneumonitis in all patients of the pneumonitis group. In the control group, however, one-sided changes of KL-6 level were not observed. In the pneumonitis group, serum LDH levels were not significantly changed. However, there was a strong correlation between the altered levels of KL-6 and those of LDH (r = 0.992). These observations indicate that the same cytopathologic changes may cause the elevation of serum KL-6 level and the elevated activity of serum LDH in the patients with radiation pneumonitis, and that KL-6 is much more sensitive than LDH for detecting radiation pneumonitis. (Chert 1992; 102:117–22)

Section snippets

Subjects

Fifteen patients with lung cancer who received radiation therapy with line accelerator were selected for this study. Six patients contracted radiation pneumonitis (pneumonitis group, Table 1) and the other nine patients did not (control group, Table 2). All patients with pneumonitis had cough and a continuous fever. Five of them showed infiltrative changes which emerged just on the irradiated area on their chest x-ray films. The remaining patient showed infiltrative shadows all over the lung

Time Course of Irradiated Patients

Followed-up levels of serum KL-6, LDH activity, and CRP are shown in Figure 1 for the pneumonitis group, and in Figure 2 for the control group.

In the pneumonitis group, all of the serum KL-6, LDH activity, and CRP developed the tendency to increase their levels before and after the diagnosis of radiation pneumonitis.

In the control group, on the other hand, serum KL-6 did not show one-sided change of the levels. Two patients, indicated by closed circles in Figure 2, showed increased KL-6 levels

DISCUSSION

Serum KL-6 appeared to be a sensitive marker for serologic diagnosis of radiation pneumonitis, and the change of its level was quite different from that of serum CRP. In all of the six patients of the pneumonitis group, serum levels of KL-6 were significantly increased from 1.7 to 63-fold according to the complication of radiation pneumonitis. In two of them, the increase was observed even before the diagnosis of pneumonitis. Though the increase of serum KL-6 level was also observed in four of

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    The Radiation Effects Research Foundation is a private nonprofit foundation, supported equally by the Government of Japan with funding from the Ministry of Health and Welfare and the Government of the United States with funding from the Department of Energy through the National Academy of Sciences.

    This study was supported in part by grant-in-aid for Scientific Research (No. 02807081) from the Ministry of Education, Science and Culture, Japan.

    Manuscript received July 22; revision accepted October 22.

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