Nonspecific interstitial pneumonia in collagen vascular diseases: comparison of the clinical characteristics and prognostic significance with usual interstitial pneumonia.
BACKGROUND
Nonspecific interstitial pneumonia (NSIP) has recently been described as a distinct clinicopathological entity among idiopathic interstitial pneumonias (IIP), having more favorable prognosis than usual interstitial pneumonia (UIP). Although NSIP was initially reported to also occur in patients with interstitial pneumonia associated with collagen vascular diseases (IP-CVD), the prevalence of NSIP and its prognostic significance in IP-CVD remains to be determined. Thus, we attempted to clarify clinical characteristics and prognostic significance of NSIP in IP-CVD.


METHODS
We histologically examined surgical lung biopsies from 43 patients with IP-CVD based on a current classification of interstitial pneumonias, and compared the clinical characteristics and prognostic significance of NSIP with UIP in IP-CVD. We also studied 98 patients with biopsy-proven NSIP and UIP in IIP, and compared the prognostic significance of histopathologic subclassification in IIP with that in IP-CVD.


RESULTS
In IP-CVD, twenty-six patients (60%) were classified as NSIP, 17 (40%) as UIP. In contrast, 76 (77%) were categorized into UIP and 22 (23%) into NSIP of the patients with IIP. No significant difference in survival rates was observed between UIP and NSIP in IP-CVD (p = 0.3863), while, in IIP, NSIP has a significant better survival than UIP (p = 0.022).


CONCLUSIONS
These results suggest that NSIP is more common histologic pattern than UIP in IP-CVD and, unlike in IIP, the prognosis of NSIP patients may not be different from that of UIP patients in IP-CVD.
Nakamura
Yutaro
Y
Second Division, Department of Internal Medicine, Hamamatsu University School of Medicine, Hamamatsu, Shizuoka, Japan.
Chida
Kingo
K
Suda
Takafimi
T
Hayakawa
Hiroshi
H
Iwata
Masatoshi
M
Imokawa
Shiro
S
Tsuchiya
Tomoyoshi
T
Ida
Masaaki
M
Gemma
Hitoshi
H
Yasuda
Kazumasa
K
Yagi
Takeshi
T
Shirai
Toshihiro
T
Tamura
Ryoji
R
Nakano
Yutaka
Y
Hirata
Takeo
T
Nakamura
Hirotoshi
H
Colby
Thomas V
TV
D000368:Aged; D001706:Biopsy; D003240:Connective Tissue Diseases / Q000150:complications*; D005260:Female; D006801:Humans; D017563:Lung Diseases, Interstitial / Q000209:etiology* / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D012189:Retrospective Studies; D016019:Survival Analysis