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CHEST:慢性超敏性肺炎的病理及预后的大型前瞻性队列性研究

2017-02-24 MedSci MedSci原创

特异性组织病理学特征预测慢性超敏性肺炎患者的死亡率或肺移植的能力是未知的。近期,一项发表咋杂志CHEST上的文章进行了这项研究。研究者们从纵向队列中筛选出通过外科肺活检诊断的慢性超敏性肺炎的患者。外科肺活检切片由有经验的病理学家评分估。使用Cox比例风险分析鉴定无移植生存的独立预测因子,并使用Kaplan-Meier分析来可视化结果。此项研究最终确定119例患者。纤维化非特异性间质性肺炎(f-NS

特异性组织病理学特征预测慢性超敏性肺炎患者的死亡率或肺移植的能力是未知的。


近期,一项发表咋杂志CHEST上的文章进行了这项研究。

研究者们从纵向队列中筛选出通过外科肺活检诊断的慢性超敏性肺炎的患者。外科肺活检切片由有经验的病理学家评分估。使用Cox比例风险分析鉴定无移植生存的独立预测因子,并使用Kaplan-Meier分析来可视化结果。

此项研究最终确定119例患者。纤维化非特异性间质性肺炎(f-NSIP),支气管中心纤维化(BF)或常见间质性肺炎(UIP)的患者比细胞NSIP(c-NSIP)或细支气管周围炎肉芽肿(PI-PFG)患者的无移植生存差。

f-NSIP、BF或UIP患者的不存在生存差异。所有病理类型的活组织检查的亚组中均鉴定了成纤维细胞灶。所有UIP病例中均观察到纤维支气管周围纤维化。死亡或移植时间的独立预测因素包括存在成纤维细胞灶或致密的胶原纤维化。

此项研究得出结论:c-NSIP和PI-PFG的组织病理类型比UIP、f-NSIP和BF类型的无移植生存更佳。成纤维细胞灶或致密胶原纤维化的存在与疾病进展为死亡或肺移植相关。组织检查鉴定成纤维细胞集落可能是临床上有效预测HP患者生存的方法。

原始出处:
Wang P, Jones KD, Urisman A et al. Pathological Findings and Prognosis in a Large Prospective Cohort of Chronic Hypersensitivity Pneumonitis. Chest. 2017 Feb 18. pii: S0012-3692(17)30220-9. doi: 10.1016/j.chest.2017.02.011.

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