{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,8]],"date-time":"2026-10-08T05:54:21Z","timestamp":1791438861096,"version":"4.3.3"},"reference-count":32,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2026,7,25]],"date-time":"2026-07-25T00:00:00Z","timestamp":1784937600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0"},{"start":{"date-parts":[[2026,10,8]],"date-time":"2026-10-08T00:00:00Z","timestamp":1791417600000},"content-version":"vor","delay-in-days":75,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["BMC Pulm Med"],"DOI":"10.1186\/s12890-026-04524-4","type":"journal-article","created":{"date-parts":[[2026,7,25]],"date-time":"2026-07-25T01:03:56Z","timestamp":1784941436000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Association of CYFRA 21-1 with quantitative CT\u2013defined fibrotic progression in idiopathic pulmonary fibrosis"],"prefix":"10.1186","volume":"26","author":[{"given":"Ji-Yeon","family":"Han","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hyun-Kyung","family":"Lee","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hongyeul","family":"Lee","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ho Young","family":"Lee","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"SungMin","family":"Hong","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yumi","family":"Bang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,7,25]]},"reference":[{"key":"4524_CR1","doi-asserted-by":"publisher","first-page":"35","DOI":"10.1016\/j.pharmthera.2016.09.010","volume":"169","author":"DL Clarke","year":"2017","unstructured":"Clarke DL, Murray LA, Crestani B, Sleeman MA. Is personalised medicine the key to heterogeneity in idiopathic pulmonary fibrosis? Pharmacol Ther. 2017;169:35\u201346.","journal-title":"Pharmacol Ther"},{"key":"4524_CR2","doi-asserted-by":"crossref","unstructured":"Maher TM, Nambiar AM, Wells AU. The role of precision medicine in interstitial lung disease. Eur Respir J. 2022;7(60):2102146.","DOI":"10.1183\/13993003.02146-2021"},{"key":"4524_CR3","doi-asserted-by":"publisher","first-page":"1400","DOI":"10.1515\/cclm-2021-0199","volume":"59","author":"E Aloisio","year":"2021","unstructured":"Aloisio E, Braga F, Puricelli C, Panteghini M. Prognostic role of Krebs von den Lungen-6 (KL-6) measurement in idiopathic pulmonary fibrosis: a systematic review and meta-analysis. Clin Chem Lab Med. 2021;59:1400\u20138.","journal-title":"Clin Chem Lab Med"},{"key":"4524_CR4","doi-asserted-by":"publisher","first-page":"334","DOI":"10.1186\/s12931-022-02273-6","volume":"23","author":"MG Choi","year":"2022","unstructured":"Choi MG, Choi SM, Lee JH, Kim JY, Song JW. Blood Krebs von den Lungen-6 levels predict treatment response to antifibrotic therapy in patients with idiopathic pulmonary fibrosis. Respir Res. 2022;23:334.","journal-title":"Respir Res"},{"key":"4524_CR5","doi-asserted-by":"publisher","first-page":"745233","DOI":"10.3389\/fimmu.2021.745233","volume":"12","author":"T Zhang","year":"2021","unstructured":"Zhang T, Shen P, Duan C, Gao L. KL-6 as an immunological biomarker predicts the severity, progression, acute exacerbation, and poor outcomes of interstitial lung disease: A systematic review and meta-analysis. Front Immunol. 2021;12:745233.","journal-title":"Front Immunol"},{"key":"4524_CR6","doi-asserted-by":"publisher","first-page":"1440","DOI":"10.1164\/rccm.202107-1769OC","volume":"205","author":"PL Molyneaux","year":"2022","unstructured":"Molyneaux PL, Fahy WA, Byrne AJ, Braybrooke R, Saunders P, Toshner R, et al. CYFRA 21\u2009\u2013\u20091 Predicts Progression in Idiopathic Pulmonary Fibrosis: A Prospective Longitudinal Analysis of the PROFILE Cohort. Am J Respir Crit Care Med. 2022;205:1440\u20138.","journal-title":"Am J Respir Crit Care Med"},{"key":"4524_CR7","doi-asserted-by":"publisher","first-page":"3","DOI":"10.1016\/j.resinv.2012.02.001","volume":"50","author":"N Ishikawa","year":"2012","unstructured":"Ishikawa N, Hattori N, Yokoyama A, Kohno N. Utility of KL-6\/MUC1 in the clinical management of interstitial lung diseases. Respir Investig. 2012;50:3\u201313.","journal-title":"Respir Investig"},{"key":"4524_CR8","doi-asserted-by":"publisher","first-page":"e44","DOI":"10.1164\/rccm.201807-1255ST","volume":"198","author":"G Raghu","year":"2018","unstructured":"Raghu G, Remy-Jardin M, Myers JL, Richeldi L, Ryerson CJ, Lederer DJ, et al. American Thoracic Society, European Respiratory Society, Japanese Respiratory Society, and Latin American Thoracic Society. Diagnosis of Idiopathic Pulmonary Fibrosis. An Official ATS\/ERS\/JRS\/ALAT Clinical Practice Guideline. Am J Respir Crit Care Med. 2018;198:e44\u201368.","journal-title":"Am J Respir Crit Care Med"},{"key":"4524_CR9","doi-asserted-by":"publisher","first-page":"218","DOI":"10.1513\/AnnalsATS.202301-084OC","volume":"21","author":"AS Oh","year":"2024","unstructured":"Oh AS, Lynch DA, Swigris JJ, Baraghoshi D, Dyer DS, Hale VA, et al. Deep learning-based fibrosis extent on computed tomography predicts outcome of fibrosing interstitial lung disease independent of visually assessed computed tomography Pattern. Ann Am Thorac Soc. 2024;21:218\u201327.","journal-title":"Ann Am Thorac Soc"},{"key":"4524_CR10","doi-asserted-by":"publisher","first-page":"2179","DOI":"10.3390\/diagnostics15172179","volume":"15","author":"A Russo","year":"2025","unstructured":"Russo A, Patan\u00e8 V, Oliva A, Viglione V, Franzese L, Forte G, et al. AI-based HRCT quantification in connective tissue disease-associated interstitial lung disease. Diagnostics. 2025;15:2179.","journal-title":"Diagnostics"},{"key":"4524_CR11","doi-asserted-by":"publisher","first-page":"8151","DOI":"10.1007\/s00330-025-11714-x","volume":"35","author":"K Lee","year":"2025","unstructured":"Lee K, Lee JH, Koh SY, Park H, Goo JM. Risk factors and prognostic indicators for progressive fibrosing interstitial lung disease: a deep learning-based CT quantification approach. Eur Radiol. 2025;35:8151\u201361.","journal-title":"Eur Radiol"},{"key":"4524_CR12","doi-asserted-by":"publisher","first-page":"1775","DOI":"10.1164\/rccm.202503-0535OC","volume":"211","author":"M Koslow","year":"2025","unstructured":"Koslow M, Baraghoshi D, Swigris JJ, Brown KK, Fern\u00e1ndez P\u00e9rez ER, et al. One-year change in quantitative computed tomography is associated with meaningful outcomes in fibrotic lung disease. Am J Respir Crit Care Med. 2025;211:1775\u201384.","journal-title":"Am J Respir Crit Care Med"},{"key":"4524_CR13","doi-asserted-by":"publisher","first-page":"1785","DOI":"10.1164\/rccm.202501-0208OC","volume":"211","author":"JM Wang","year":"2025","unstructured":"Wang JM, Adegunsoye A, Pugashetti JV, Lee CT, Murray S, Mohan N, et al. A quantitative imaging measure of progressive pulmonary fibrosis. Am J Respir Crit Care Med. 2025;211:1785\u201393.","journal-title":"Am J Respir Crit Care Med"},{"key":"4524_CR14","doi-asserted-by":"publisher","first-page":"523","DOI":"10.1186\/s12890-024-03344-8","volume":"24","author":"B Shin","year":"2024","unstructured":"Shin B, Oh YJ, Kim J, Park SG, Lee KS, Lee HY. Correlation between CT-based phenotypes and serum biomarker in interstitial lung diseases. BMC Pulm Med. 2024;24:523.","journal-title":"BMC Pulm Med"},{"key":"4524_CR15","doi-asserted-by":"publisher","first-page":"73","DOI":"10.1186\/s12931-020-01335-x","volume":"21","author":"J W\u00e4lscher","year":"2020","unstructured":"W\u00e4lscher J, Witt S, Schwarzkopf L, Kreuter M. Hospitalisation patterns of patients with interstitial lung disease in the light of comorbidities and medical treatment - a German claims data analysis. Respir Res. 2020;21:73.","journal-title":"Respir Res"},{"key":"4524_CR16","doi-asserted-by":"publisher","first-page":"e70","DOI":"10.1164\/rccm.201908-1590ST","volume":"200","author":"BL Graham","year":"2019","unstructured":"Graham BL, Steenbruggen I, Miller MR, Barjaktarevic IZ, Cooper BG, Hall GL, et al. Standardization of Spirometry 2019 Update. An Official American Thoracic Society and European Respiratory Society Technical Statement. Am J Respir Crit Care Med. 2019;200:e70\u201388.","journal-title":"Am J Respir Crit Care Med"},{"key":"4524_CR17","doi-asserted-by":"publisher","first-page":"4195","DOI":"10.1007\/s00330-023-10483-9","volume":"34","author":"SY Koh","year":"2024","unstructured":"Koh SY, Lee JH, Park H, Goo JM. Value of CT quantification in progressive fibrosing interstitial lung disease: a deep learning approach. Eur Radiol. 2024;34:4195\u2013205.","journal-title":"Eur Radiol"},{"key":"4524_CR18","doi-asserted-by":"publisher","first-page":"4696","DOI":"10.1016\/j.acra.2024.05.005","volume":"31","author":"Y Ahn","year":"2024","unstructured":"Ahn Y, Kim HC, Lee JK, Noh HN, Choe J, Seo JB, et al. Usefulness of CT Quantification-Based Assessment in Defining Progressive Pulmonary Fibrosis. Acad Radiol. 2024;31:4696\u2013708.","journal-title":"Acad Radiol"},{"issue":"5","key":"4524_CR19","doi-asserted-by":"publisher","first-page":"1255","DOI":"10.1016\/j.chest.2025.11.031","volume":"169","author":"S Park","year":"2026","unstructured":"Park S, Kim MJ, Lee JH, Hwang HJ, Lee SM, Chae EJ, et al. Quantitative CT Imaging in Progressive Pulmonary Fibrosis: Clinical Usefulness and Meaningful Threshold Definition. Chest. 2026;169(5):1255\u201366.","journal-title":"Chest"},{"key":"4524_CR20","doi-asserted-by":"publisher","first-page":"110697","DOI":"10.1016\/j.clinimag.2025.110697","volume":"130","author":"H Park","year":"2026","unstructured":"Park H, Han JY, Baek J. Quantification differences between supine and prone CT in interstitial lung disease. Clin Imaging. 2026;130:110697.","journal-title":"Clin Imaging"},{"key":"4524_CR21","doi-asserted-by":"publisher","first-page":"e18","DOI":"10.1164\/rccm.202202-0399ST","volume":"205","author":"G Raghu","year":"2022","unstructured":"Raghu G, Remy-Jardin M, Richeldi L, Thomson CC, Inoue Y, Johkoh T, et al. Idiopathic Pulmonary Fibrosis (an Update) and Progressive Pulmonary Fibrosis in Adults: An Official ATS\/ERS\/JRS\/ALAT Clinical Practice Guideline. Am J Respir Crit Care Med. 2022;205:e18\u201347.","journal-title":"Am J Respir Crit Care Med"},{"key":"4524_CR22","doi-asserted-by":"publisher","first-page":"289","DOI":"10.1214\/10-STS330","volume":"25","author":"G Shmueli","year":"2010","unstructured":"Shmueli G. To explain or to predict? Stat Sci. 2010;25:289\u2013310.","journal-title":"Stat Sci"},{"issue":"17","key":"4524_CR23","doi-asserted-by":"publisher","first-page":"1801384","DOI":"10.1183\/13993003.01384-2018","volume":"52","author":"SM Humphries","year":"2018","unstructured":"Humphries SM, Swigris JJ, Brown KK, Strand M, Gong Q, Sundy JS, et al. Quantitative high-resolution computed tomography fibrosis score: performance characteristics in idiopathic pulmonary fibrosis. Eur Respir J. 2018;52(17):1801384.","journal-title":"Eur Respir J"},{"issue":"1","key":"4524_CR24","doi-asserted-by":"publisher","first-page":"437","DOI":"10.1186\/s12890-024-03254-9","volume":"24","author":"H Zhang","year":"2024","unstructured":"Zhang H, Li X, Zhang X, Yuan Y, Zhao C, Zhang J. Quantitative CT analysis of idiopathic pulmonary fibrosis and correlation with lung function study. BMC Pulm Med. 2024;24(1):437.","journal-title":"BMC Pulm Med"},{"key":"4524_CR25","doi-asserted-by":"publisher","first-page":"143","DOI":"10.1016\/j.pulmoe.2018.05.008","volume":"25","author":"H Qin","year":"2019","unstructured":"Qin H, Xu XP, Zou J, Zhao XJ, Wu HW, Zha QF, et al. Krebs von den Lungen-6 associated with chest high-resolution CT score in evaluation severity of patients with interstitial lung disease. Pulmonology. 2019;25:143\u20138.","journal-title":"Pulmonology"},{"key":"4524_CR26","doi-asserted-by":"publisher","first-page":"1131","DOI":"10.1016\/j.rmed.2004.04.003","volume":"98","author":"F Kinoshita","year":"2004","unstructured":"Kinoshita F, Hamano H, Harada H, Kinoshita T, Igishi T, Hagino H, et al. Role of KL-6 in evaluating the disease severity of rheumatoid lung disease: comparison with HRCT. Respir Med. 2004;98:1131\u20137.","journal-title":"Respir Med"},{"key":"4524_CR27","doi-asserted-by":"publisher","first-page":"e27561","DOI":"10.1016\/j.heliyon.2024.e27561","volume":"10","author":"T Wang","year":"2024","unstructured":"Wang T, Yao Y, Wang Y, Wei W, Yin B, Huang M, et al. Evaluating the diagnostic and therapeutic significance of KL-6 in patients with interstitial lung diseases. Heliyon. 2024;10:e27561.","journal-title":"Heliyon"},{"key":"4524_CR28","doi-asserted-by":"publisher","first-page":"e0244114","DOI":"10.1371\/journal.pone.0244114","volume":"15","author":"UW Ko","year":"2020","unstructured":"Ko UW, Cho EJ, Oh HB, Koo HJ, Do KH, Song JW. Serum Krebs von den Lungen-6 level predicts disease progression in interstitial lung disease. PLoS ONE. 2020;15:e0244114.","journal-title":"PLoS ONE"},{"key":"4524_CR29","doi-asserted-by":"publisher","first-page":"240006","DOI":"10.1183\/20734735.0006-2024","volume":"20","author":"C Lederer","year":"2024","unstructured":"Lederer C, Storman M, Tarnoki AD, Tarnoki DL, Margaritopoulos GA, Prosch H. Imaging in the diagnosis and management of fibrosing interstitial lung diseases. Breathe. 2024;20:240006.","journal-title":"Breathe"},{"key":"4524_CR30","first-page":"12","volume":"20","author":"C Chung","year":"2022","unstructured":"Chung C, Kim J, Cho HS, Kim HC. Baseline serum Krebs von den Lungen-6 as a biomarker for the disease progression in idiopathic pulmonary fibrosis. Sci Rep. 2022;20:12.","journal-title":"Sci Rep"},{"key":"4524_CR31","doi-asserted-by":"publisher","first-page":"152366","DOI":"10.1016\/j.semarthrit.2024.152366","volume":"65","author":"C Sieiro Santos","year":"2024","unstructured":"Sieiro Santos C, Antol\u00edn SC, Lorenzo JC, Garay CL, Morales CM, de Miguel EB, et al. KL6 and IL-18 levels are negatively correlated with respiratory function tests and ILD extent assessed on HRCT in patients with systemic sclerosis-related interstitial lung disease. Semin Arthritis Rheum. 2024;65:152366.","journal-title":"Semin Arthritis Rheum"},{"key":"4524_CR32","doi-asserted-by":"crossref","unstructured":"Lee JS, Lee EY, Ha YJ, Kang EH, Lee YJ, Song YW. Serum KL-6 levels reflect the severity of interstitial lung disease associated with connective tissue disease. Arthritis Res Ther. 2019;14(21):58.","DOI":"10.1186\/s13075-019-1835-9"}],"container-title":["BMC Pulmonary Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/article\/10.1186\/s12890-026-04524-4","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s12890-026-04524-4.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s12890-026-04524-4.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,10,8]],"date-time":"2026-10-08T05:30:14Z","timestamp":1791437414000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/10.1186\/s12890-026-04524-4"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,7,25]]},"references-count":32,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2026,12]]}},"alternative-id":["4524"],"URL":"https:\/\/doi.org\/10.1186\/s12890-026-04524-4","relation":{"has-preprint":[{"id-type":"doi","id":"10.21203\/rs.3.rs-9178775\/v1","asserted-by":"object"}]},"ISSN":["1471-2466"],"issn-type":[{"value":"1471-2466","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,7,25]]},"assertion":[{"value":"20 March 2026","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"20 July 2026","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"25 July 2026","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"This retrospective study was approved by the Institutional Review Board of Inje University Busan Paik Hospital, and the requirement of written informed consent was waived (No. BPIRB 2024-11-034). All procedures involving human participants were performed in accordance with the relevant guidelines and regulations, including the Declaration of Helsinki.","order":1,"name":"Ethics","label":"Ethics approval and consent to participate","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"Not applicable.","order":2,"name":"Ethics","label":"Consent for publication","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"The authors declare no competing interests.","order":3,"name":"Ethics","label":"Competing interests","group":{"name":"EthicsHeading","label":"Declarations"}}],"article-number":"453"}}