Medium-long term prognosis prediction for idiopathic pulmonary fibrosis patients based on quantitative analysis of fibrotic lung volume.
Medium-long term prognosis prediction for idiopathic pulmonary fibrosis patients based on quantitative analysis of fibrotic lung volume.
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DOI：
10.1186/s12931-022-02276-3
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发表时间：
2022-12-22
影响因子：
5.8
通讯作者：
Chen, Zhihong
中科院分区：
文献类型：
--
作者：
Du, Kaifeng;Zhu, Yichun;Mao, Ruolin;Qu, Yubei;Cui, Bo;Ma, Yuan;Zhang, Xin;Chen, Zhihong
通过定量分析特发性肺纤维化（IPF）患者的纤维化程度，探讨CT定量分析的预后价值，并试图为个体患者提供准确的中长期预后预测。这是一项回顾性队列研究，纳入复旦大学附属中山医院的95例IPF患者。纳入2009年至2015年首次诊断为IPF的64例患者作为推导队列。收集关于性别、年龄、性别-年龄-生理学（GAP）指数、高分辨率计算机断层扫描（HRCT）图像、生存状态和肺功能参数的信息，包括用力肺活量（FVC）、FVC预测百分比（FVC%pred）、一氧化碳弥散量（DLCO）、DLCO预测百分比（DLCO%pred）、一氧化碳转移系数（KCO）、KCO预测百分比（KCO%pred）。31例患者被纳入验证队列。使用Synapse 3D软件定量纤维化肺体积（FLV）和总肺体积（TLV）。计算FLV与TLV的比值，并标记为CTFLV/TLV%，反映纤维化程度。通过单变量分析和多变量分析，对所有生理变量和CTFLV/TLV%进行生存维度分析。通过逻辑回归计算基于基线CTFLV/TLV%预测死亡概率的公式，并通过验证队列进行验证。单因素分析显示CTFLV/TLV%沿着DLCO%pred、KCO%pred和GAP指数与生存率显著相关。然而，在多变量分析中，只有CTFLV/TLV%对预后预测有意义（HR 1.114，95%CI 1.047-1.184，P = 0.0006），根据受试者工作特征（ROC）曲线分析，最佳临界值为11%。CTFLV/TLV% ≤ 11%和CTFLV/TLV% > 11%组的存活时间显著不同。根据CTFLV/TLV%数据，可使用特定公式计算患者在1年、3年和5年时的死亡概率。经验证队列检验，该公式具有较高的敏感性（88.2%）、特异性（92.8%）和准确性（90.3%）。CT定量容积分析可用于评估肺纤维化的程度。CTFLV/TLV%可能是一个有价值的生物标志物，用于准确预测IPF患者的中长期预后。
To investigate the prognostic value of quantitative analysis of CT among patients with idiopathic pulmonary fibrosis (IPF) by quantifying the fibrosis extent and to attempt to provide precise medium-long term prognostic predictions for individual patients. This was a retrospective cohort study that included 95 IPF patients in Zhongshan Hospital, Fudan University. 64 patients firstly diagnosed with IPF from 2009 to 2015 was included as the derivation cohort. Information regarding sex, age, the Gender-Age-Physiology (GAP) index, high-resolution computed tomography (HRCT) images, survival status, and pulmonary function parameters including forced vital capacity (FVC), FVC percent predicted (FVC%pred), diffusing capacity of carbon monoxide (DLCO), DLCO percent predicted (DLCO%pred), carbon monoxide transfer coefficient (KCO), KCO percent predicted (KCO%pred) were collected. 31 patients were included in the validation cohort. The Synapse 3D software was used to quantify the fibrotic lung volume (FLV) and total lung volume (TLV). The ratio of FLV to TLV was calculated and labeled CTFLV/TLV%, reflecting the extent of fibrosis. All the physiological variants and CTFLV/TLV% were analyzed for the dimension of survival through both univariate analysis and multivariate analysis. Formulas for predicting the probability of death based on the baseline CTFLV/TLV% were calculated by logistic regression, and validated by the validation cohort. The univariate analysis indicated that CTFLV/TLV% along with DLCO%pred, KCO%pred and GAP index were significantly correlated with survival. However, only CTFLV/TLV% was meaningful in the multivariate analysis for prognostic prediction (HR 1.114, 95% CI 1.047–1.184, P = 0.0006), and the best cutoff was 11%, based on receiver operating characteristic (ROC) curve analysis. The survival times for the CTFLV/TLV% ≤ 11% and CTFLV/TLV% > 11% groups were significantly different. Given the CTFLV/TLV% data, the death probability of a patient at 1 year, 3 years and 5 years could be calculated by using a particular formula. The formulas were tested by the validation cohort, showed high sensitivity (88.2%), specificity (92.8%) and accuracy (90.3%). Quantitative volume analysis of CT might be useful for evaluating the extent of fibrosis in the lung. The CTFLV/TLV% could be a valuable biomarker for precisely predicting the medium-long term prognosis of individual patients with IPF.
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DOI：
10.1164/rccm.2111053
发表时间：
2003-04-01
影响因子：
24.7
作者：
Wells, AU;Desai, SR;Hansell, DM
通讯作者：
Hansell, DM
影响因子：
9.6
作者：
KANENGISER, LC;RAPOPORT, DM;GOLDRING, RM
通讯作者：
GOLDRING, RM
影响因子：
8.3
作者：
Paterniti, Miya O.;Bi, Youwei;Chowdhury, Badrul A.
通讯作者：
Chowdhury, Badrul A.
影响因子：
24.3
作者：
Maldonado, Fabien;Moua, Teng;Ryu, Jay H.
通讯作者：
Ryu, Jay H.
影响因子：
19.7
作者：
Best, Alan C.;Meng, Jiangfeng;Lynch, David A.
通讯作者：
Lynch, David A.