Computed Tomography Predictors of Mortality or Disease Progression in Systemic Sclerosis-Interstitial Lung Disease: A Systematic Review.

Computed Tomography Predictors of Mortality or Disease Progression in Systemic Sclerosis-Interstitial Lung Disease: A Systematic Review.
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DOI:
10.3389/fmed.2021.807982
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发表时间:
2021
影响因子:
3.9
通讯作者:
Matucci-Cerinic M
Matucci-Cerinic M
中科院分区:
医学3区
文献类型:
--
作者:
Landini N;Orlandi M;Bruni C;Carlesi E;Nardi C;Calistri L;Morana G;Tomassetti S;Colagrande S;Matucci-Cerinic M

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尽管间质性肺病(ILD)是系统性硬化症(SSc)发病和死亡的主要原因,但其诊断仍具有挑战性。鉴于CT是ILD评估的金标准成像技术,对胸部CT结果作为SSc-ILD死亡率或ILD进展的预测因子进行了系统性综述。检索了三个数据库(Medline、Embase和Web of Science),以识别从开始到2020年12月分析SSc-ILD中CT死亡率或ILD进展预测因子的所有研究。ILD进展定义为用力肺活量和/或CT ILD结果恶化。排除了非英语书写、全文不可用、未关注SSc-ILD或未外推SSc-ILD、否则有重叠综合征、儿科患者、<10例病例或CT特征以外的预测因素的患者。在3,513篇引文中,15篇全文(2,332例SSc-ILD患者)符合入选标准。ILD范围和广泛ILD、ILD密度分析参数、纤维化范围和网状化范围是独立的死亡预测因素。广泛ILD也是死亡、需要补充氧气或肺移植的独立预测因素。蜂窝程度是呼吸道死亡的独立危险因素。未确定ILD进展的独立预测因素。ILD范围和广泛ILD独立预测CT显示的SSc-ILD死亡率,以及ILD密度分析、纤维化范围和网状化范围。广泛ILD也是死亡、需要补充氧气或肺移植的预测因子。蜂窝程度预测呼吸道死亡率。ILD进展的CT预测因子需要进一步研究。https://www.crd.york.ac.uk/prospero/,PROSPERO,标识符:CRD 420202005001。
Although interstitial lung disease (ILD) is a major cause of morbidity and mortality in systemic sclerosis (SSc), its prognostication remains challenging. Given that CT represents the gold standard imaging technique in ILD assessment, a systematic review on chest CT findings as predictors of mortality or ILD progression in SSc-ILD was performed. Three databases (Medline, Embase, and Web of Science) were searched to identify all studies analyzing CT mortality or ILD progression predictors in SSc-ILD, from inception to December 2020. ILD progression was defined by worsening of forced vital capacity and/or CT ILD findings. Manuscripts not written in English, with not available full-text, not focusing on SSc-ILD or with SSc-ILD not extrapolated, otherwise with overlap syndromes, pediatric patients, <10 cases or predictors other than CT features were excluded. Out of 3,513 citations, 15 full-texts (2,332 patients with SSc-ILD) met the inclusion criteria. ILD extent and extensive ILD, ILD densitometric analysis parameters, fibrotic extent and reticulation extent resulted as independent mortality predictors. Extensive ILD is also an independent predictor of death, need for supplemental oxygen or lung transplantation. Honeycombing extent is an independent risk factor for respiratory mortality. Independent predictors of ILD progression were not identified. ILD extent and extensive ILD independently predict mortality in SSc-ILD on CT, as well as ILD densitometric analysis, fibrotic extent and reticulation extent. Extensive ILD is also a predictor of death, need for supplemental oxygen, or lung transplantation. Honeycombing extent predicts respiratory mortality. CT predictors of ILD progression need to be further investigated. https://www.crd.york.ac.uk/prospero/, PROSPERO, identifier: CRD420202005001.
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