Cargando…

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

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...

Descripción completa

Detalles Bibliográficos
Autores principales: Ozasa, Mutsumi, Ichikawa, Hiromi, Sato, Shuntaro, Tanaka, Tomonori, Johkoh, Takeshi, Kataoka, Kensuke, Yamano, Yasuhiko, Kondoh, Yasuhiro, Nakamura, Hideki, Kawakami, Atsushi, Bychkov, Andrey, Taniguchi, Hiroyuki, Fukuoka, Junya
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Public Library of Science 2018
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6218032/
https://www.ncbi.nlm.nih.gov/pubmed/30395623
http://dx.doi.org/10.1371/journal.pone.0206186
_version_ 1783368385055162368
author Ozasa, Mutsumi
Ichikawa, Hiromi
Sato, Shuntaro
Tanaka, Tomonori
Johkoh, Takeshi
Kataoka, Kensuke
Yamano, Yasuhiko
Kondoh, Yasuhiro
Nakamura, Hideki
Kawakami, Atsushi
Bychkov, Andrey
Taniguchi, Hiroyuki
Fukuoka, Junya
author_facet Ozasa, Mutsumi
Ichikawa, Hiromi
Sato, Shuntaro
Tanaka, Tomonori
Johkoh, Takeshi
Kataoka, Kensuke
Yamano, Yasuhiko
Kondoh, Yasuhiro
Nakamura, Hideki
Kawakami, Atsushi
Bychkov, Andrey
Taniguchi, Hiroyuki
Fukuoka, Junya
author_sort Ozasa, Mutsumi
collection PubMed
description 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.
format Online
Article
Text
id pubmed-6218032
institution National Center for Biotechnology Information
language English
publishDate 2018
publisher Public Library of Science
record_format MEDLINE/PubMed
spelling pubmed-62180322018-11-19 Proposed method of histological separation between connective tissue disease-associated interstitial pneumonia and idiopathic interstitial pneumonias Ozasa, Mutsumi Ichikawa, Hiromi Sato, Shuntaro Tanaka, Tomonori Johkoh, Takeshi Kataoka, Kensuke Yamano, Yasuhiko Kondoh, Yasuhiro Nakamura, Hideki Kawakami, Atsushi Bychkov, Andrey Taniguchi, Hiroyuki Fukuoka, Junya PLoS One Research Article 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. Public Library of Science 2018-11-05 /pmc/articles/PMC6218032/ /pubmed/30395623 http://dx.doi.org/10.1371/journal.pone.0206186 Text en © 2018 Ozasa et al http://creativecommons.org/licenses/by/4.0/ This is an open access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0/) , which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
spellingShingle Research Article
Ozasa, Mutsumi
Ichikawa, Hiromi
Sato, Shuntaro
Tanaka, Tomonori
Johkoh, Takeshi
Kataoka, Kensuke
Yamano, Yasuhiko
Kondoh, Yasuhiro
Nakamura, Hideki
Kawakami, Atsushi
Bychkov, Andrey
Taniguchi, Hiroyuki
Fukuoka, Junya
Proposed method of histological separation between connective tissue disease-associated interstitial pneumonia and idiopathic interstitial pneumonias
title Proposed method of histological separation between connective tissue disease-associated interstitial pneumonia and idiopathic interstitial pneumonias
title_full Proposed method of histological separation between connective tissue disease-associated interstitial pneumonia and idiopathic interstitial pneumonias
title_fullStr Proposed method of histological separation between connective tissue disease-associated interstitial pneumonia and idiopathic interstitial pneumonias
title_full_unstemmed Proposed method of histological separation between connective tissue disease-associated interstitial pneumonia and idiopathic interstitial pneumonias
title_short Proposed method of histological separation between connective tissue disease-associated interstitial pneumonia and idiopathic interstitial pneumonias
title_sort proposed method of histological separation between connective tissue disease-associated interstitial pneumonia and idiopathic interstitial pneumonias
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6218032/
https://www.ncbi.nlm.nih.gov/pubmed/30395623
http://dx.doi.org/10.1371/journal.pone.0206186
work_keys_str_mv AT ozasamutsumi proposedmethodofhistologicalseparationbetweenconnectivetissuediseaseassociatedinterstitialpneumoniaandidiopathicinterstitialpneumonias
AT ichikawahiromi proposedmethodofhistologicalseparationbetweenconnectivetissuediseaseassociatedinterstitialpneumoniaandidiopathicinterstitialpneumonias
AT satoshuntaro proposedmethodofhistologicalseparationbetweenconnectivetissuediseaseassociatedinterstitialpneumoniaandidiopathicinterstitialpneumonias
AT tanakatomonori proposedmethodofhistologicalseparationbetweenconnectivetissuediseaseassociatedinterstitialpneumoniaandidiopathicinterstitialpneumonias
AT johkohtakeshi proposedmethodofhistologicalseparationbetweenconnectivetissuediseaseassociatedinterstitialpneumoniaandidiopathicinterstitialpneumonias
AT kataokakensuke proposedmethodofhistologicalseparationbetweenconnectivetissuediseaseassociatedinterstitialpneumoniaandidiopathicinterstitialpneumonias
AT yamanoyasuhiko proposedmethodofhistologicalseparationbetweenconnectivetissuediseaseassociatedinterstitialpneumoniaandidiopathicinterstitialpneumonias
AT kondohyasuhiro proposedmethodofhistologicalseparationbetweenconnectivetissuediseaseassociatedinterstitialpneumoniaandidiopathicinterstitialpneumonias
AT nakamurahideki proposedmethodofhistologicalseparationbetweenconnectivetissuediseaseassociatedinterstitialpneumoniaandidiopathicinterstitialpneumonias
AT kawakamiatsushi proposedmethodofhistologicalseparationbetweenconnectivetissuediseaseassociatedinterstitialpneumoniaandidiopathicinterstitialpneumonias
AT bychkovandrey proposedmethodofhistologicalseparationbetweenconnectivetissuediseaseassociatedinterstitialpneumoniaandidiopathicinterstitialpneumonias
AT taniguchihiroyuki proposedmethodofhistologicalseparationbetweenconnectivetissuediseaseassociatedinterstitialpneumoniaandidiopathicinterstitialpneumonias
AT fukuokajunya proposedmethodofhistologicalseparationbetweenconnectivetissuediseaseassociatedinterstitialpneumoniaandidiopathicinterstitialpneumonias