A histologic pattern of nonspecific interstitial pneumonia is associated with a better prognosis than usual interstitial pneumonia in patients with cryptogenic fibrosing alveolitis
A histologic pattern of nonspecific interstitial pneumonia is associated with a better prognosis than usual interstitial pneumonia in patients with cryptogenic fibrosing alveolitis
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DOI：
10.1164/ajrccm.160.3.9903021
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发表时间：
1999-09-01
影响因子：
24.7
通讯作者：
du Bois, RM
中科院分区：
文献类型：
--
作者：
Daniil, ZD;Gilchrist, FC;du Bois, RM
本研究旨在探讨隐源性纤维化肺泡炎（CFA）的预后是否与组织学模式相关，以及临床和影像学表现与组织学之间是否存在相关性。本文回顾了为诊断弥漫性肺疾病而连续进行的113例肺活检，并使用间质性肺炎的Katzenstein和Myers标准进行了重新分类。排除了入院时缺乏完整研究数据的患者和易患肺纤维化的患者，留下15例诊断为非特异性间质性肺炎（NSIP）和15例诊断为常规间质性肺炎（UIP）。比较两组患者1998年11月的临床和影像学表现、肺功能信息和生存状况。与UIP组相比，NSIP组的生存率显著高于UIP组（p < 0.001）。这不能用待遇的不同来解释。UIP患者表现出肺功能的进行性恶化，而NSIP患者则保持稳定。CT扫描显示，UIP患者的纤维化程度高于NSIP患者（p < 0.011）。与UIP相比，NSIP的组织学诊断与更好的预后相关。CFA的这种亚分类在临床上是有用的。
This study aimed to investigate whether there was a difference in outcome related to histologic pattern in cryptogenic fibrosing alveolitis (CFA) and to see whether there were correlations between clinical and radiologic findings and histology. One hundred thirteen lung biopsies from consecutive patients taken for the diagnosis of diffuse lung disease were reviewed and reclassified using the Katzenstein and Myers criteria for interstitial pneumonias. Patients lacking full investigational data at presentation and those with conditions predisposing to lung fibrosis were excluded, leaving 15 patients diagnosed with nonspecific interstitial pneumonia (NSIP) and 15 with usual interstitial pneumonia (UIP). Clinical and radiologic findings at presentation and serial lung function information and survival status in November 1998 were compared for the two groups. Survival was found to be significantly greater in the NSIP group compared with the UIP group (p < 0.001). This could not be explained by differences in treatment. Patients with UIP showed a progressive deterioration in lung function whereas those with NSIP remained stable. CT scans of patients with UIP showed more fibrosis than those of patients with NSIP (p < 0.011). A histologic diagnosis of NSIP is associated with a better prognosis than UIP. This subclassification of CFA is clinically useful.