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特发性间质性肺炎相关性系统性硬化症患者采用自体外周血造血干细胞移植治疗的预处理或随访 CT 表现与疗效的相关性研究

Correlation between pretreatment or follow-up CT findings and therapeutic effect of autologous peripheral blood stem cell transplantation for interstitial pneumonia associated with systemic sclerosis.

机构信息

Department of Clinical Radiology, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka 812-8582, Japan.

出版信息

Eur J Radiol. 2011 Aug;79(2):e74-9. doi: 10.1016/j.ejrad.2011.03.078. Epub 2011 Apr 22.

DOI:10.1016/j.ejrad.2011.03.078
PMID:21514756
Abstract

PURPOSE

To evaluate what is useful among various parameters including CT findings, laboratory parameters (%VC, %DLco, KL-6), patients related data (age, sex, duration of disease) to discriminate between responder and non-responder in patients who received autologous peripheral blood stem cell transplantation (auto-PBSCT) for interstitial pneumonia (IP) with systemic sclerosis (SSc).

METHOD

Auto-PBSCT and follow-up of at least one year by chest CT, serum KL-6, %VC, and %DLco were performed in 15 patients for IP with SSc. Analyzed CT findings included extent of ground-glass opacity (GGO), intralobular reticular opacity, number of segments that showed traction bronchiectasis, and presence of honeycombing. We regarded the therapeutic response of patients as responders when TLC or VC increase over 10% or DLco increase more than 15%, otherwise we have classified as non-responder. We applied univariate and multivariate analyses to find the significant indicators to discriminate responders from non-responders. P<0.05 was considered statistically significant.

RESULTS

Univariate and multivariate analyses showed that the significant parameter to discriminate responders from non-responders were pretreatment KL-6, presence of honeycombing, extent of GGO, and early change in extent of GGO. Among them, extent of GGO and early change in extent of GGO were the strongest discriminators between responders and non-responders (P=0.001, 0.001, respectively).

CONCLUSION

Several CT findings and pretreatment KL-6 may be useful to discriminate between responder and non-responder in patients who received auto-PBSCT for IP with SSc.

摘要

目的

评估在接受自体外周血干细胞移植(auto-PBSCT)治疗系统性硬化症(SSc)间质性肺炎(IP)的患者中,哪些参数(CT 表现、实验室参数[VC%、DLco%]、患者相关数据[年龄、性别、疾病持续时间])有助于区分应答者和无应答者。

方法

对 15 例接受自体 PBSCT 治疗的 IP-SSc 患者进行了胸部 CT、血清 KL-6、VC%和 DLco 的随访,随访时间至少为 1 年。分析的 CT 表现包括磨玻璃影(GGO)程度、小叶内网状影、出现牵引性支气管扩张的节段数和蜂窝肺的存在。当 TLC 或 VC 增加 10%以上或 DLco 增加 15%以上时,我们将患者的治疗反应视为应答者,否则归类为无应答者。我们应用单变量和多变量分析来寻找区分应答者和无应答者的显著指标。P<0.05 被认为具有统计学意义。

结果

单变量和多变量分析显示,区分应答者和无应答者的显著参数是治疗前 KL-6、蜂窝肺的存在、GGO 程度和 GGO 程度的早期变化。其中,GGO 程度和 GGO 程度的早期变化是区分应答者和无应答者的最强指标(P=0.001,0.001)。

结论

几项 CT 表现和治疗前 KL-6 可能有助于区分接受自体 PBSCT 治疗的 SSc-IP 患者的应答者和无应答者。

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