Divisions of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Seoul National University College of Medicine, Seoul National University Bundang Hospital, 82 Gumi-Ro 173 Beon-Gil, Bundang-Gu, Seongnam, Gyeonggi-Do, 13620, South Korea.
Department of Pathology, Seoul National University College of Medicine, Seoul National University Bundang Hospital, Seongnam, South Korea.
Sci Rep. 2023 Feb 16;13(1):2804. doi: 10.1038/s41598-023-28638-5.
Higher blood monocyte counts are related to worse survival in idiopathic pulmonary fibrosis. However, studies evaluating the association between blood monocyte counts and clinical outcomes of idiopathic nonspecific interstitial pneumonia (iNSIP) are lacking. We evaluated the impact of monocyte counts on iNSIP prognosis. iNSIP patients (n = 126; median age, 60 years; female, n = 64 [50.8%]) diagnosed by surgical lung biopsy were enrolled and categorized into low (monocyte < 600/µL) and high (monocyte ≥ 600/µL) monocyte groups. The median follow-up duration was 53.0 months. After adjusting for age, sex, and smoking history, the annual decline in forced vital capacity (FVC) showed differences between the monocyte groups (P = 0.006) (low vs. high; - 28.49 mL/year vs. - 65.76 mL/year). The high-monocyte group showed a worse survival rate (P = 0.01) compared to low monocyte group. The 5-year survival rates were 83% and 72% in the low- and high-monocyte groups, respectively. In the Cox-proportional hazard analysis, older age, male sex, low baseline FVC, and diffusing capacity of the lung for carbon monoxide were independent risk factors for mortality. However, monocyte count (Hazard ratio 1.61, P = 0.126) was not an independent prognostic factor. Although high monocyte count might be associated with faster lung function decline, it could not independently predict survival in iNSIP.
外周血单核细胞计数与特发性肺纤维化患者的生存预后相关。然而，目前评估特发性非特异性间质性肺炎（iNSIP）患者外周血单核细胞计数与临床结局关系的研究较少。本研究旨在评估外周血单核细胞计数对 iNSIP 预后的影响。
连续纳入 126 例经外科肺活检确诊的 iNSIP 患者（中位年龄 60 岁，女性 64 例[50.8%]），并根据外周血单核细胞计数分为低（单核细胞计数＜600/μL）和高（单核细胞计数≥600/μL）两组。中位随访时间为 53.0 个月。校正年龄、性别和吸烟史后，两组患者的用力肺活量（FVC）年下降率存在差异（P=0.006）（低 vs. 高：-28.49 mL/年 vs. -65.76 mL/年）。高单核细胞组的生存率低于低单核细胞组（P=0.01）。低单核细胞组和高单核细胞组的 5 年生存率分别为 83%和 72%。Cox 比例风险分析显示，高龄、男性、基线 FVC 较低和一氧化碳弥散量是死亡的独立危险因素。而单核细胞计数（风险比 1.61，P=0.126）不是独立的预后因素。尽管高外周血单核细胞计数可能与更快的肺功能下降相关，但不能独立预测 iNSIP 的生存情况。
