Katsaras Matthaios, Sotiropoulou Vasilina, Manali Effrosyni, Fouka Evangelia, Papakosta Despoina, Bendstrup Elisabeth, Kolilekas Lykourgos, Tomos Ioannis, Tzilas Vasilios, Ntolios Paschalis, Steiropoulos Paschalis, Papanikolaou Ilias, Gogali Athena, Kostikas Konstantinos, Tsiri Panagiota, Papaioannou Ourania, Malakounidou Elli, Theohari Eva, Christopoulos Ioannis, Sampsonas Fotios, Papiris Spyridon A, Rovina Nikoletta, Bouros Demosthenes, Tzouvelekis Argyrios
Department of Respiratory Medicine, University Hospital of Patras, 26500 Patras, Greece.
1st Respiratory Department, Sotiria Chest Hospital, Medical School, National and Kapodistrian University of Athens, 11527 Athens, Greece.
Diagnostics (Basel). 2025 Apr 18;15(8):1038. doi: 10.3390/diagnostics15081038.
Hypersensitivity pneumonitis (HP) represents a chronic lung disease with an unpredictable clinical course. There is a pressing need for clinically applicable prognostic biomarkers in patients with HP. This was an observational, retrospective study. We investigated the prognostic potential of complete blood count parameters in treatment-naïve patients diagnosed with HP between 15 December 2010 and 1 October 2023. Receiver operating characteristic (ROC) curve analysis identified the optimal cut-off thresholds for each parameter in terms of mortality prediction. We included 129 patients diagnosed with HP [median age: 68.0 years (95% CI: 65.0 to 69.0), fibrotic HP: = 85, 65.9%]. Patients with HP and an eosinophil count > 160 cells/μL [ROC curve, area under curve (AUC): 0.61] exhibited increased mortality risk compared to patients with HP and an eosinophil count ≤ 160 cells/μL [Kaplan-Meier, HR: 2.95 (95% CI: 1.36 to 6.42), = 0.006]. Patients with HP and a monocyte count > 350 cells/μL (ROC curve, AUC: 0.52) had worse survival compared to patients with HP and a monocyte count lower than this threshold [Kaplan-Meier, HR: 2.48 (95% CI: 1.03 to 5.09), = 0.04]. Patients with HP and an eosinophil-lymphocyte ratio (ELR) > 0.09 (ROC curve, AUC: 0.64) had a higher risk of mortality compared to patients with HP and ELR ≤ 0.09 [Kaplan-Meier, HR: 2.75 (95% CI: 1.3 to 5.78), = 0.008]. This study demonstrated that eosinophil count, monocyte count, and ELR could be prognostic biomarkers in patients with HP. Further studies aiming to validate the prognostic potential of complete blood count parameters in patients with HP are greatly anticipated.
过敏性肺炎（HP）是一种临床病程不可预测的慢性肺部疾病。HP患者迫切需要临床适用的预后生物标志物。这是一项观察性回顾性研究。我们调查了2010年12月15日至2023年10月1日期间初治的HP诊断患者全血细胞计数参数的预后潜力。受试者工作特征（ROC）曲线分析确定了每个参数在死亡率预测方面的最佳截断阈值。我们纳入了129例HP诊断患者[中位年龄：68.0岁（95%CI：65.0至69.0），纤维化HP：=85，65.9%]。与嗜酸性粒细胞计数≤160个/μL的HP患者相比，嗜酸性粒细胞计数>160个/μL的HP患者[ROC曲线，曲线下面积（AUC）：0.61]死亡风险增加[Kaplan-Meier，HR：2.95（95%CI：1.36至6.42），=0.006]。与单核细胞计数低于此阈值的HP患者相比，单核细胞计数>350个/μL的HP患者（ROC曲线，AUC：0.52）生存情况更差[Kaplan-Meier，HR：2.48（95%CI：1.03至5.09），=0.04]。与ELR≤0.09的HP患者相比，嗜酸性粒细胞-淋巴细胞比值（ELR）>0.09的HP患者（ROC曲线，AUC：0.64）死亡风险更高[Kaplan-Meier，HR：2.75（95%CI：1.3至5.78），=0.008]。本研究表明，嗜酸性粒细胞计数、单核细胞计数和ELR可能是HP患者的预后生物标志物。非常期待进一步的研究来验证HP患者全血细胞计数参数的预后潜力。
