Predictive role of inflammatory markers in characterizing the progression of interstitial lung disease: a retrospective analysis.

OBJECTIVES

To evaluate the association between inflammatory markers and interstitial lung disease (ILD) progression in order to enhance disease monitoring and risk stratification.

METHODS

This retrospective cohort study analyzed the clinical data from 172 ILD patients admitted to Nanjing Jiangbei Hospital between January 2021 and December 2023. Patients were categorized into two groups: progressive ILD (PILD; n=95) and rapidly progressive ILD (RPILD; n=77), based on changes in symptoms and pulmonary function within six months. PILD was defined by a ≥10% relative decline in predicted Forced Vital Capacity (ppFVC) or related clinical criteria. RPILD was defined by acute symptom worsening and significant pulmonary function deterioration. Inflammatory markers assessed included C-reactive protein (CRP), neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), lymphocyte-to-monocyte ratio (LMR), and systemic immune-inflammation index (SII).

RESULTS

CRP, NLR, PLR, and SII levels were significantly higher in the RPILD group, while LMR was significantly lower (all P<0.05). Multivariate logistic regression identified CRP, NLR, LMR, and SII as independent predictors of ILD progression. ROC analysis showed NLR had the highest individual predictive value (AUC=0.757). A composite model combining all five markers achieved an AUC of 0.842, indicating improved predictive accuracy.

CONCLUSIONS

Inflammatory markers, particularly NLR, are independently associated with ILD progression. A composite model incorporating multiple markers offers enhanced predictive performance, potentially supporting clinical decision-making and early intervention strategies.