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Surfactant protein-D predicts survival in patients with idiopathic pulmonary fibrosis
N P Barlo1, C H M van Moorsel, H J T Ruven
1Centre for Interstitial Lung Diseases, Department of Pulmonology, St. Antonius Hospital Nieuwegein, The Netherlands.
Background:
Idiopathic pulmonary fibrosis is a progressive interstitial lung disease with a high mortality rate. As lung transplantation is the only therapeutic option, it is important to predict survival.
Objective:
This study evaluates the clinical value of surfactant protein-D as a marker of prognosis in patients with idiopathic pulmonary fibrosis.
Design:
Surfactant protein-D was measured in serum of 72 patients and 305 healthy controls. The optimal cut-off level to define unfavourable prognosis was determined using a ROC analysis. A Cox's proportional Hazards model was used to evaluate variables that were significant predictors of survival.
Results:
Serum levels of surfactant protein-D were significantly higher in patients than in controls. ROC analysis showed 460 ng/ml to be the optimal cut-off level to discriminate survivor from non-survivors after 1 year. Patients with high levels (> 460 ng/ml) had a median survival time of 13 months, compared to 67 months in the group with low levels (< 460 ng/ml). Surfactant protein-D showed to be a significant predictor of prognosis, even when corrected for age, sex, smoking, and lung function.
Conclusion:
The measurement of surfactant protein-D in serum of patients with idiopathic pulmonary fibrosis might be a clinically relevant tool to predict survival.
