Association of Clinical and Radiological Features with Disease Severity of Symptomatic Immune Checkpoint Inhibitor-Related Pneumonitis.
Association of Clinical and Radiological Features with Disease Severity of Symptomatic Immune Checkpoint Inhibitor-Related Pneumonitis.
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DOI：
10.3390/diagnostics13040691
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发表时间：
2023-02-12
期刊：
影响因子：
3.6
通讯作者：
Wu, Ning
中科院分区：
文献类型：
--
作者：
Zhang, Qian;Tao, Xiuli;Zhao, Shijun;Li, Ning;Wang, Shuhang;Wu, Ning
关键词：
目的：探讨临床和胸部计算机断层扫描 (CT) 特征对症状性免疫检查点抑制剂相关肺炎 (CIP) 严重程度的预测能力。方法：本研究纳入了 34 名被诊断为有症状 CIP（2-5 级）的患者，分为轻度（2 级）和重度 CIP（3-5 级）组。分析各组的临床和胸部CT特征。进行三个手动评分（范围、图像发现和临床症状评分）来单独和组合评估诊断性能。结果：轻度CIP 20例，重度CIP 14例。 3 个月内发生的 CIP 比 3 个月后更严重（11 例 vs. 3 例，p = 0.038）。严重 CIP 与发热 (p < 0.001) 和急性间质性肺炎/急性呼吸窘迫综合征模式 (p = 0.001) 显着相关。胸部CT评分（范围评分和影像发现评分）的诊断性能优于临床症状评分。三个评分的组合显示出最佳的诊断价值，受试者工作特征曲线下面积为 0.948。结论：临床及胸部CT特征对评估症状性CIP的病情严重程度具有重要的应用价值。我们建议在综合临床评估中常规使用胸部 CT。
Objectives: To investigate the predictive ability of clinical and chest computed tomography (CT) features to predict the severity of symptomatic immune checkpoint inhibitor-related pneumonitis (CIP). Methods: This study included 34 patients diagnosed with symptomatic CIP (grades 2–5) and divided into mild (grade 2) and severe CIP (grades 3–5) groups. The groups’ clinical and chest CT features were analyzed. Three manual scores (extent, image finding, and clinical symptom scores) were conducted to evaluate the diagnostic performance alone and in combination. Results: There were 20 cases of mild CIP and 14 cases of severe CIP. More severe CIP occurred within 3 months than after 3 months (11 vs. 3 cases, p = 0.038). Severe CIP was significantly associated with fever (p < 0.001) and the acute interstitial pneumonia/acute respiratory distress syndrome pattern (p = 0.001). The diagnostic performance of chest CT scores (extent score and image finding score) was better than that of clinical symptom score. The combination of the three scores demonstrated the best diagnostic value, with an area under the receiver operating characteristic curve of 0.948. Conclusions: The clinical and chest CT features have important application value in assessing the disease severity of symptomatic CIP. We recommend the routine use of chest CT in a comprehensive clinical evaluation.
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DOI：
10.1016/j.jrid.2020.05.001
发表时间：
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期刊：
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