The radiological patterns of interstitial change at an early phase: Over a 4-year follow-up
The radiological patterns of interstitial change at an early phase: Over a 4-year follow-up
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DOI：
10.1016/j.rmed.2010.05.014
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发表时间：
2010-11-01
影响因子：
4.3
通讯作者：
Kubo, Keishi
中科院分区：
文献类型：
--
作者：
Tsushima, Kenji;Sone, Shusuke;Kubo, Keishi
目的：早期间质改变的识别可能影响对特发性间质性肺炎的认识。本研究旨在阐明肺癌的放射学类型及其与吸烟的关系。方法：受试者接受低剂量CT扫描以筛查肺癌。选择有间质改变的受试者，使用高分辨率计算机断层扫描(HRCT)监测间质改变的精确形态。将受试者分为HRCT正常组和异常组。分析HRCT、血清Klebs von der lugen-6(KL-6)、肺表面活性蛋白(SP-A)、SP-D、肺功能和CT评分的影像表现。根据放射学类型对HRCT异常受试者进行分类，并对其进行为期4年的随访。结果：在3079名受试者中，有80人发现HRCT异常提示间质改变。7名蜂窝状患者和14名合并肺纤维化和肺气肿(CPFE)的患者被确诊。蜂窝型性行为(男性)和吸烟率均高于其他类型。HRCT异常组吸烟史和血清KL-6、SP-A、SP-D水平显著高于正常组。在73名HRCT异常的受试者中，有32名在4年期间胸部HRCT的CT评分有进展。18例HRCT异常的吸烟者参与了CT评分的进展。结论：排除小叶间隔增厚的HRCT模式显示了CT评分的进展。有CT异常的吸烟者可能有表现出间质病变恶化的趋势。(C)2010爱思唯尔有限公司。保留所有权利。
Objectives: The identification of early phase interstitial changes may influence the understanding of idiopathic interstitial pneumonitis. This study aimed to clarify its radiological patterns and the association with smoking.Methods: The subjects underwent low-dose computed tomography to screen lung cancer. The selected subjects with interstitial changes were monitored for the precise morphology of interstitial changes using a high-resolution computed tomography (HRCT) scan. The subjects were classified into normal and abnormal HRCT subjects. The radiological findings on the HRCT scan, serum Klebs von der Lungen-6 (KL-6), surfactant protein (SP)-A, SP-D, pulmonary function, and computed tomography (CT) scores were analyzed. Abnormal HRCT subjects were classified based on the radiological patterns, and were followed-up over a 4-year period.Results: HRCT abnormalities suggesting interstitial changes were identified in 80 of 3079 subjects. Seven subjects with honeycombing and 14 with combined pulmonary fibrosis and emphysema (CPFE) were identified. The frequencies of sex (male) and smoking in the subjects with honeycombing was higher than that of other patterns. The smoking history and the levels of serum KL-6, SP-A, and SP-D in abnormal HRCT subjects were significantly higher than those in normal HRCT subjects. Thirty-two of 73 abnormal HRCT subjects showed a progression of the CT scores in a chest HRCT over a 4-year period. Eighteen abnormal HRCT current smokers were included in the progression of CT scores.Conclusions: HRCT patterns, excluding interlobular septal thickening, show the progression of CT scores. Smokers with CT abnormalities may have a tendency to demonstrate worsening interstitial changes. (C) 2010 Elsevier Ltd. All rights reserved.