E. Diot et al., PREDICTIVE VALUE OF SERUM-III PROCOLLAGEN FOR DIAGNOSIS OF PULMONARY INVOLVEMENT IN PATIENTS WITH SCLERODERMA, The European respiratory journal, 8(9), 1995, pp. 1559-1565
High resolution computed tomography (HRCT) was recently demonstrated t
o be as good as open lung biopsy for the diagnosis of pulmonary involv
ement in patients with scleroderma Nevertheless, in view of its price
and related irradiation, HRCT cannot be recommended as a screening tes
t, Serum III procollagen (sPIIINP) is an aminopropeptide of type III c
ollagen, which is released during conversion into collagen by specific
proteases. Increased levels of sPIIINP have been observed in patients
with scleroderma The aim of the present study was to assess the relat
ionship between sPIIINP measurement and pulmonary involvement defined
according to HRCT and pulmonary function tests (PFT) with single-breat
h carbon monoxide transfer capacity (TL,CO) in 28 patients suffering f
rom scleroderma. Patients were divided into two groups for analysis. G
roup A comprising 16 patients without pulmonary scleroderma and Group
B comprising 12 patients with pulmonary scleroderma. All patients had
stable cutaneous disease and normal renal and hepatic function. The le
vel of sPIIINP was determined by radioimmunoassay (RIA-gnost P-III-P,
Prod. Nr. ODMT; Behring, Marburg, Germany). Mean+/-sD sPIIINP level in
Group A was 0.85+/-0.1 U . mL(-1).Individual values ranged 0.6-13 U .
mL(-1). Mean+/-sD sPIIINP value was 1.30-0.40 U . mL(-1) in Group B a
nd individual values ranged 0.7-1.9 U . mL(-1). The difference in mean
sPIIINP level between Group A and Group B was significant. Using a cu
t-off at 1.1 U . mL(-1), sensitivity of sPIIINP was 0.66, specificity
0.94, positive predictive value 0.89, negative predictive value 0.79,
false positive rate 0.06, and false negative rate 033, The value of sP
IIINP correlated with HRCT score but not with PFT. This study confirms
the relationship between sPIIINP and scleroderma with interstitial lu
ng disease. We suggest that sPIIINP could be measured in patients with
scleroderma to screen those patients requiring HRCT. Further studies
are necessary to determine the value of sPIIINP in terms of prognosis
and follow-up of patients under treatment.