Relationship between fibroblastic foci profusion and high resolution CT morphology in fibrotic lung diseaseReportar como inadecuado




Relationship between fibroblastic foci profusion and high resolution CT morphology in fibrotic lung disease - Descarga este documento en PDF. Documentación en PDF para descargar gratis. Disponible también para leer online.

BMC Medicine

, 13:241

First Online: 24 September 2015Received: 27 April 2015Accepted: 03 September 2015DOI: 10.1186-s12916-015-0479-0

Cite this article as: Walsh, S.L.F., Wells, A.U., Sverzellati, N. et al. BMC Med 2015 13: 241. doi:10.1186-s12916-015-0479-0

Abstract

BackgroundFibroblastic foci profusion on histopathology and severity of traction bronchiectasis on highresolution computed tomography HRCT have been shown to be predictors of mortality in patients with idiopathic pulmonary fibrosis IPF. The aim of this study was to investigate the relationship between fibroblastic foci FF profusion and HRCT patterns in patients with a histopathologic diagnosis of usual interstitial pneumonia UIP, fibrotic non-specific interstitial pneumonia NSIP and chronic hypersensitivity pneumonitis CHP.

MethodsThe HRCT scans of 162 patients with a histopathologic diagnosis of UIP or fibrotic NSIP n = 162 were scored on extent of groundglass opacification, reticulation, honeycombing, emphysema and severity of traction bronchiectasis. For each patient, a fibroblastic foci profusion score based on histopathologic appearances was assigned. Relationships between extent of fibroblastic foci and individual HRCT patterns were investigated using univariate correlation analysis and multivariate linear regression.

ResultsIncreasing extent of reticulation P < 0.0001 and increasing severity of traction bronchiectasis P < 0.0001 were independently associated with increasing FF score within the entire cohort. Within individual multidisciplinary team diagnosis subgroups, the only significant independent association with FF score was severity of traction bronchiectasis in patients with idiopathic pulmonary fibrosis IPF-UIP n = 66, r = 0.19, P < 0.0001 and patients with chronic hypersensitivity pneumonitis CHP n = 49, r = 0.45, P < 0.0001. Furthermore, FF score had the strongest association with severity of traction bronchiectasis in patients with IPF r = 0.34, P < 0.0001 and CHP r = 0.35, P < 0.0001. There was no correlation between FF score and severity of traction bronchiectasis in patients with fibrotic NSIP. Global disease extent had the strongest association with severity of traction bronchiectasis in patients with fibrotic NSIP r = 0.58, P < 0.0001.

ConclusionIn patients with fibrotic lung disease, profusion of fibroblastic foci is strikingly related to the severity of traction bronchiectasis, particularly in IPF and CHP. This may explain the growing evidence that traction bronchiectasis is a predictor of mortality in several fibrotic lung diseases.

KeywordsInterstitial lung disease Idiopathic pulmonary fibrosis Fibroblastic foci Bronchiectasis Survival AbbreviationsCHPchronic hypersensitivity pneumonitis

CPIcomposite physiological index

CTDconnective tissue disease

FFfibroblastic foci score

HRCThigh resolution computed tomography

IPFidiopathic pulmonary fibrosis

NSIPnon-specific interstitial pneumonia

UIPusual interstitial pneumonia

Download fulltext PDF



Autor:

Fuente: https://link.springer.com/







Documentos relacionados