Proposed method of histological separation between connective tissue disease-associated interstitial pneumonia and idiopathic interstitial pneumonias

Autor: Hiroyuki Taniguchi, Hiromi Ichikawa, Andrey Bychkov, Tomonori Tanaka, Shuntaro Sato, Atsushi Kawakami, Hideki Nakamura, Yasuhiro Kondoh, Yasuhiko Yamano, Kensuke Kataoka, Junya Fukuoka, Mutsumi Ozasa, Takeshi Johkoh
Jazyk: angličtina
Rok vydání: 2018
Předmět:
Male
Pathology
Pulmonology
Medical Doctors
Health Care Providers
Biopsy
lcsh:Medicine
Biochemistry
Computer Applications
Fats
Mathematical and Statistical Techniques
0302 clinical medicine
Usual interstitial pneumonia
Medicine and Health Sciences
Odds Ratio
Medical Personnel
030212 general & internal medicine
Connective Tissue Diseases
lcsh:Science
Lymphoid Follicles
Multidisciplinary
medicine.diagnostic_test
Statistics
Middle Aged
Lipids
Connective tissue disease
Professions
Exact test
Physical Sciences
Web-Based Applications
Regression Analysis
Female
Anatomy
Research Article
Computer and Information Sciences
medicine.medical_specialty
Histology
Surgical and Invasive Medical Procedures
Research and Analysis Methods
Lymphatic System
Diagnosis
Differential
03 medical and health sciences
medicine
Humans
Idiopathic Interstitial Pneumonias
Statistical Methods
Idiopathic interstitial pneumonia
business.industry
lcsh:R
Plasmacytosis
Biology and Life Sciences
Pneumonia
Smooth muscle hyperplasia
medicine.disease
Pathologists
Health Care
ROC Curve
030228 respiratory system
People and Places
Population Groupings
lcsh:Q
Lung Diseases
Interstitial
business
Mathematics
Zdroj: PLoS ONE, Vol 13, Iss 11, p e0206186 (2018)
PLoS ONE
ISSN: 1932-6203
Popis: Objectives Idiopathic interstitial pneumonia (IIP) and connective tissue disease-associated interstitial pneumonia (CTD-IP) are the two most common types of interstitial pneumonia. IIP and CTD-IP share common histological features, yet their clinical management is different. Separation of the two conditions based solely on histology can be challenging, and there are no established criteria. Materials and methods We selected 105 consecutive cases of IIP (79 usual interstitial pneumonia and 26 non-specific interstitial pneumonia) and 49 cases of CTD-IP for derivation and 32 cases of IIP and 10 cases of CTD-IP for validation. Fourteen histological parameters were evaluated independently by two pathologists for derivation group and graded into 0 to 3. The association between the score for each marker and a diagnosis of CTD was investigated using Fisher’s exact test and stepwise logistic regression analysis. A formula for calculating the probability of IIP and CTD-IP was constructed by the markers identified in the regression test with coefficients for each finding. The formula was confirmed using validation case group. Results Stepwise logistic regression analysis showed that plasmacytosis, lymphoid follicle with germinal center, and airspace fibrin were suggestive of CTD-IP and that fibroblastic foci, smooth muscle hyperplasia, cellular IP, dense perivascular collagen, and fat metaplasia were suggestive of IIP. The formula used to calculate the probabilities based on estimated values for each finding was created, and user-friendly web based app was composed at www.ctdip.com. On the validation study, 30 out of 32 IIP and eight out of 10 CTD-IPs were distinguished correctly by the app (Specificity: 93%, Sensitivity: 80%). Conclusions We identified histological markers and derived a practical formula and user-friendly app to distinguish CTD-IPs from IIP.
PLoS ONE, 13(11), art.no.e0206186; 2018
Databáze: OpenAIRE
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