Long-term follow-up high-resolution CT findings in non-specific interstitial pneumonia
Long-term follow-up high-resolution CT findings in non-specific interstitial pneumonia
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DOI：
10.1136/thx.2010.140574
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发表时间：
2011-01-01
期刊：
影响因子：
10
通讯作者：
Kawata, Yutaka
中科院分区：
文献类型：
--
作者：
Akira, Masanori;Inoue, Yoshikazu;Kawata, Yutaka
背景本研究的目的是回顾性评估非特异性间质性肺炎（NSIP;中位数，72个月;范围，3-216个月）患者的随访CT扫描结果的变化，并阐明基线CT结果与mortality.Methods之间的相关性。两名观察员独立评估高分辨率CT（HRCT）结果，并将每个病例分为以下三类之一：（1）符合NSIP，（2）符合UIP或（3）提示替代诊断。HRCT结果与死亡率之间的相关性进行了评估，使用Kaplan-Meier方法和对数秩检验，以及考克斯比例风险回归models.Results磨玻璃样阴影和实变减少，而粗糙的纤维化和牵引性支气管扩张增加的后续HRCT扫描，然而，在78%的情况下，实质异常的整体程度没有变化或减少。HRCT诊断符合NSIP的患者比HRCT结果更符合UIP或替代诊断的患者生存期更长。多因素分析显示，单纯纤维化程度与预后相关（HR：1.480; 95%CI：1.100 ~ 1.990）。结论：病理诊断为NSIP的患者HRCT表现呈多样化。一些患者的总体疾病程度可能会随着时间的推移而降低，而另一些患者的纤维化可能会进展。最初的HRCT诊断可能会影响这组患者的生存率。
Background The aims of this study were to retrospectively assess the change in findings on follow-up CT scans of patients with non-specific interstitial pneumonia (NSIP; median, 72 months; range, 3-216 months) and to clarify the correlation between the baseline CT findings and mortality.Methods The study included 50 patients with a histologic diagnosis of NSIP. Two observers evaluated the high-resolution CT (HRCT) findings independently and classified each case into one of the following three categories: (1) compatible with NSIP, (2) compatible with UIP or (3) suggestive of alternative diagnosis. The correlation between the HRCT findings and mortality was evaluated using the Kaplan-Meier method and the log-rank test, as well as Cox proportional hazards regression models.Results Ground-glass opacity and consolidation decreased, whereas coarseness of fibrosis and traction bronchiectasis increased on the follow-up HRCT scans, however, in 78% of cases the overall extent of parenchymal abnormalities had no change or decreased. Patients with HRCT diagnosed compatible with NSIP had a longer survival than those with HRCT findings more compatible UIP or an alternative diagnosis. On multivariate analysis, the coarseness of fibrosis alone was associated with prognosis (HR: 1.480; 95% CIs 1.100 to 1.990).Conclusions The HRCT patterns seen in patients with a histopathologic diagnosis of NSIP progress in a variable manner. Overall disease extent may decrease over time in some, while fibrosis may progress in others. The initial HRCT diagnosis may impact survival in this group of patients.