胶原血管病中的非特异性间质性肺炎：与普通间质性肺炎的临床特征及预后意义比较

Nonspecific interstitial pneumonia in collagen vascular diseases: comparison of the clinical characteristics and prognostic significance with usual interstitial pneumonia.

作者信息

Nakamura Yutaro, Chida Kingo, Suda Takafimi, Hayakawa Hiroshi, Iwata Masatoshi, Imokawa Shiro, Tsuchiya Tomoyoshi, Ida Masaaki, Gemma Hitoshi, Yasuda Kazumasa, Yagi Takeshi, Shirai Toshihiro, Tamura Ryoji, Nakano Yutaka, Hirata Takeo, Nakamura Hirotoshi, Colby Thomas V

机构信息

Second Division, Department of Internal Medicine, Hamamatsu University School of Medicine, Hamamatsu, Shizuoka, Japan.

出版信息

Sarcoidosis Vasc Diffuse Lung Dis. 2003 Oct;20(3):235-41.

PMID:14620168

Abstract

BACKGROUND

Nonspecific interstitial pneumonia (NSIP) has recently been described as a distinct clinicopathological entity among idiopathic interstitial pneumonias (IIP), having more favorable prognosis than usual interstitial pneumonia (UIP). Although NSIP was initially reported to also occur in patients with interstitial pneumonia associated with collagen vascular diseases (IP-CVD), the prevalence of NSIP and its prognostic significance in IP-CVD remains to be determined. Thus, we attempted to clarify clinical characteristics and prognostic significance of NSIP in IP-CVD.

METHODS

We histologically examined surgical lung biopsies from 43 patients with IP-CVD based on a current classification of interstitial pneumonias, and compared the clinical characteristics and prognostic significance of NSIP with UIP in IP-CVD. We also studied 98 patients with biopsy-proven NSIP and UIP in IIP, and compared the prognostic significance of histopathologic subclassification in IIP with that in IP-CVD.

RESULTS

In IP-CVD, twenty-six patients (60%) were classified as NSIP, 17 (40%) as UIP. In contrast, 76 (77%) were categorized into UIP and 22 (23%) into NSIP of the patients with IIP. No significant difference in survival rates was observed between UIP and NSIP in IP-CVD (p = 0.3863), while, in IIP, NSIP has a significant better survival than UIP (p = 0.022).

CONCLUSIONS

These results suggest that NSIP is more common histologic pattern than UIP in IP-CVD and, unlike in IIP, the prognosis of NSIP patients may not be different from that of UIP patients in IP-CVD.

摘要

背景

非特异性间质性肺炎（NSIP）最近被描述为特发性间质性肺炎（IIP）中的一种独特的临床病理实体，其预后比寻常型间质性肺炎（UIP）更有利。尽管最初报道NSIP也发生于与胶原血管疾病相关的间质性肺炎（IP-CVD）患者中，但NSIP在IP-CVD中的患病率及其预后意义仍有待确定。因此，我们试图阐明NSIP在IP-CVD中的临床特征和预后意义。

方法

我们根据当前的间质性肺炎分类对43例IP-CVD患者的手术肺活检组织进行了组织学检查，并比较了NSIP与UIP在IP-CVD中的临床特征和预后意义。我们还研究了98例经活检证实为IIP中的NSIP和UIP患者，并比较了IIP中组织病理学亚分类与IP-CVD中的预后意义。

结果

在IP-CVD中，26例（60%）被分类为NSIP，17例（40%）为UIP。相比之下，IIP患者中76例（77%）被归类为UIP，22例（23%）为NSIP。在IP-CVD中，UIP和NSIP的生存率没有显著差异（p = 0.3863），而在IIP中，NSIP的生存率明显优于UIP（p = 0.022）。