Quantitative analysis of fibroblastic foci in usual interstitial pneumonia
Quantitative analysis of fibroblastic foci in usual interstitial pneumonia
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DOI：
10.1378/chest.130.1.22
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发表时间：
2006-07-01
期刊：
影响因子：
9.6
通讯作者：
Chida, Kingo
中科院分区：
文献类型：
--
作者：
Enomoto, Noriyuki;Suda, Takafumi;Chida, Kingo
研究目的：使用半定量评分方法，一些研究表明，成纤维细胞病灶（FIT）的数量，这是普通型间质性肺炎（UIP）的病理特征之一，是UIP的一个重要预后因素。在这些研究中，由一组肺病理学家在几个量表上半定量评价FF的程度。然而，由于观察者之间的差异不小，因此评价有些主观。此外，这些方法并不完全实用，因为需要两个或更多的病理学家。在这项研究中，我们试图开发一种更定量的FF评分方法。患者和方法：使用电荷耦合器件照相机，我们对15名与胶原血管病（CVD）相关的UIP患者[CVD-UIP]和16名特发性肺纤维化（IPF）患者[IPF/UIP]的肺切片进行了成像，并利用图像分析软件计算FF区域在目标图像区域中所占的比例。我们的定量评分方法使我们能够容易地和客观地评估FF的程度作为FF面积的定量百分比（%FF）评分。在我们的方法中，观察者间和观察者内的相关性很高（分别为r = 0.877和r = 0.898）。IPF/UIP患者的定量%FF评分（SD）为1.67 ± 0.90%，显著高于CVD-UIP患者（0.39- 0.24%，p < 0.0001）。考克斯比例风险模型显示，定量%FF评分是UIP患者生存的重要预测因子。定量%FF评分与先前报道的半定量评分方法评估的评分相关，但具有半定量方法评估的相同评分的患者通过我们的方法评估的评分差异很大。这些结果表明，我们对FF的定量评分方法比以前报道的半定量评分方法更客观，提供UIP患者预后的准确信息。
Study objectives: Using semiquantitative scoring methods, several studies have shown that the amount of fibroblastic foci (FIT), which are one of the pathologic characteristics in usual interstitial pneumonia (UIP), is a significant prognostic factor of UIP. In those studies, the degree of FF was evaluated semiquantitatively on several scales by a panel of pulmonary pathologists. However, the evaluation was somewhat subjective because interobserver variation was not small. Additionally, these methods are not entirely practical because two or more pathologists are required. In this study, we tried to develop a more quantitative scoring method of FF.Patients and methods: With a charge-coupled device camera, we made images of lung sections obtained from 15 patients with UIP associated with collagen vascular disease (CVD) [CVD-UIP] and 16 patients with idiopathic pulmonary fibrosis (IPF) [IPF/UIP], and calculated the proportion of FF areas in the target image areas with an image analytic software.Measurements and results: Our quantitative scoring method enabled us to readily and objectively evaluate the extent of FF as a quantitative percentage of FF area (%FF) score. Interobserver and intraobserver correlations were high in our method (r = 0.877 and r = 0.898, respectively). The quantitative %FF score (SD) of IPF/UIP patients was 1.67 +/- 0.90%, which was significantly higher than that of CVD-UIP patients (0.39-0.24%, p < 0.0001). A Cox proportional hazards model showed that the quantitative %FF score was a significant predictor of survival in UIP patients. The quantitative %FF score had a correlation with scores assessed by the semiquantitative scoring methods previously reported, but patients with the same score assessed by the semiquantitative methods had widely varying scores assessed by our method.Conclusions: These results suggest that our quantitative scoring method for FF is more objective than the semiquantitative scoring methods previously reported, providing accurate information about the prognosis of patients with UIP.