类风湿肺疾病：54 例活检证实病例的预后分析。

Rheumatoid lung disease: prognostic analysis of 54 biopsy-proven cases.

机构信息

Second Division, Department of Internal Medicine, Hamamatsu University School of Medicine, 1-20-1 Handayama, Hamamatsu, Shizuoka 431-3192, Japan.

出版信息

Respir Med. 2012 Aug;106(8):1164-9. doi: 10.1016/j.rmed.2012.04.004. Epub 2012 May 3.

DOI:10.1016/j.rmed.2012.04.004

PMID:22560113

Abstract

OBJECTIVE

To investigate the prognostic significance of histopathological characteristics in patients with biopsy-proven rheumatoid lung disease (RLD).

MATERIALS AND METHODS

Retrospective analysis was conducted on samples from 54 RLD patients who underwent surgical lung biopsies (SLBs) at Hamamatsu University Hospital and affiliated hospitals between 1980 and 2009. The overall survival rate, the spectrum of histopathological diagnosis and their associated prognostic significance were investigated.

RESULTS

The study group consisted of 30 men and 24 women with a median age of 60.3 years. Histopathological analysis revealed the following: usual interstitial pneumonia (UIP), 15 cases; nonspecific interstitial pneumonia/fibrosis, 16 cases; organizing pneumonia, 4 cases; unclassifiable, 2 cases; desquamative interstitial pneumonia, 1 case; and bronchiolar disease, 16 cases. In survival outcome, 10 yr survival rate was 76.6%. Patients with UIP had significantly worse prognosis than those with non-UIP (RLD cases except those with UIP) (p = 0.0452).

CONCLUSION

RLD includes several histopathological groups. Patients with UIP have worse survival than those with other types of RLD. Histopathological diagnosis may have a major impact on prognostication in patients with RLD.

摘要

目的

探讨经活检证实的类风湿肺疾病（RLD）患者组织病理学特征的预后意义。

材料与方法

回顾性分析了 1980 年至 2009 年期间在滨松大学医院及其附属医院接受外科肺活检（SLB）的 54 例 RLD 患者的样本。研究了总体生存率、组织病理学诊断谱及其相关的预后意义。

结果

研究组包括 30 名男性和 24 名女性，中位年龄为 60.3 岁。组织病理学分析显示：普通间质性肺炎（UIP）15 例；非特异性间质性肺炎/纤维化 16 例；机化性肺炎 4 例；无法分类 2 例；脱屑性间质性肺炎 1 例；和细支气管炎 16 例。在生存结果方面，10 年生存率为 76.6%。UIP 患者的预后明显差于非 UIP 患者（除 UIP 外的所有 RLD 患者）（p = 0.0452）。