Increased monocyte level is a risk factor for radiological progression in patients with early fibrotic interstitial lung abnormality
Background Interstitial lung abnormalities (ILA) are specific spatial patterns on computed tomography (CT) scan potentially compatible with early interstitial lung disease. A proportion will progress; management involves risk stratification and surveillance. Elevated blood monocyte levels have been...
| Main Authors: | , , , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
European Respiratory Society
2022-07-01
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| Series: | ERJ Open Research |
| Online Access: | http://openres.ersjournals.com/content/8/3/00226-2022.full |
| _version_ | 1797809419707219968 |
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| author | Andrew Achaiah Paul Lyon Emily Fraser Peter Saunders Rachel Hoyles Rachel Benamore Ling-Pei Ho |
| author_facet | Andrew Achaiah Paul Lyon Emily Fraser Peter Saunders Rachel Hoyles Rachel Benamore Ling-Pei Ho |
| author_sort | Andrew Achaiah |
| collection | DOAJ |
| description | Background
Interstitial lung abnormalities (ILA) are specific spatial patterns on computed tomography (CT) scan potentially compatible with early interstitial lung disease. A proportion will progress; management involves risk stratification and surveillance. Elevated blood monocyte levels have been shown to associate with progression of idiopathic pulmonary fibrosis. The aims of the present study were: 1) to estimate the proportion of “early fibrotic” (EF)-ILAs (reticular±ground-glass opacities, excluding traction bronchiectasis and honeycombing) on CT scans of patients attending all-indications thoracic CTs, and proportion demonstrating radiological progression; and 2) to explore association between peripheral blood leukocyte levels and ILA progression.
Methods
We analysed all thoracic CT reports in individuals aged 45–75 years performed between January 2015 and December 2020 in one large teaching hospital (Oxford, UK) to identify patient CT reports consistent with EF-ILA. CT-contemporaneous blood leukocyte counts were examined to explore contribution to progression and all-cause mortality, using multivariate Cox regression.
Results
40 711 patients underwent thoracic CT imaging during this period. 1259 (3.1%) demonstrated the EF-ILA pattern (mean±sd age 65.4±7.32 years; 735 (47.8%) male). EF-ILA was significantly associated with all-cause mortality (hazard ratio 1.87, 95% CI 1.25–2.78; p=0.002). 362 cases underwent at least one follow-on CT. Radiological progression was observed in 157 (43.4%) cases: increase in reticulation n=51, new traction bronchiectasis n=84, honeycombing n=22. Monocyte count, neutrophil count, monocyte:lymphocyte ratio, neutrophil:lymphocyte ratio and “systemic inflammatory response index” were significantly associated with radiological progression.
Conclusion
3.1% of subjects requiring thoracic CT during a 6-year period demonstrated EF-ILA. Monocyte levels and blood leukocyte-derived indexes were associated with radiological progression and could indicate which patients may require closer follow-up. |
| first_indexed | 2024-03-13T06:52:26Z |
| format | Article |
| id | doaj.art-267669db3b384a299d68173b804fd7ae |
| institution | Directory Open Access Journal |
| issn | 2312-0541 |
| language | English |
| last_indexed | 2024-03-13T06:52:26Z |
| publishDate | 2022-07-01 |
| publisher | European Respiratory Society |
| record_format | Article |
| series | ERJ Open Research |
| spelling | doaj.art-267669db3b384a299d68173b804fd7ae2023-06-07T13:30:18ZengEuropean Respiratory SocietyERJ Open Research2312-05412022-07-018310.1183/23120541.00226-202200226-2022Increased monocyte level is a risk factor for radiological progression in patients with early fibrotic interstitial lung abnormalityAndrew Achaiah0Paul Lyon1Emily Fraser2Peter Saunders3Rachel Hoyles4Rachel Benamore5Ling-Pei Ho6 MRC Human Immunology Unit, Weatherall Institute of Molecular Medicine, University of Oxford, Oxford, UK Oxford Radiology Unit, Oxford University Hospitals NHS Foundation Trust, Oxford, UK Oxford Interstitial Lung Disease Service, Oxford University Hospitals NHS Foundation Trust, Oxford, UK Oxford Interstitial Lung Disease Service, Oxford University Hospitals NHS Foundation Trust, Oxford, UK Oxford Interstitial Lung Disease Service, Oxford University Hospitals NHS Foundation Trust, Oxford, UK Oxford Radiology Unit, Oxford University Hospitals NHS Foundation Trust, Oxford, UK MRC Human Immunology Unit, Weatherall Institute of Molecular Medicine, University of Oxford, Oxford, UK Background Interstitial lung abnormalities (ILA) are specific spatial patterns on computed tomography (CT) scan potentially compatible with early interstitial lung disease. A proportion will progress; management involves risk stratification and surveillance. Elevated blood monocyte levels have been shown to associate with progression of idiopathic pulmonary fibrosis. The aims of the present study were: 1) to estimate the proportion of “early fibrotic” (EF)-ILAs (reticular±ground-glass opacities, excluding traction bronchiectasis and honeycombing) on CT scans of patients attending all-indications thoracic CTs, and proportion demonstrating radiological progression; and 2) to explore association between peripheral blood leukocyte levels and ILA progression. Methods We analysed all thoracic CT reports in individuals aged 45–75 years performed between January 2015 and December 2020 in one large teaching hospital (Oxford, UK) to identify patient CT reports consistent with EF-ILA. CT-contemporaneous blood leukocyte counts were examined to explore contribution to progression and all-cause mortality, using multivariate Cox regression. Results 40 711 patients underwent thoracic CT imaging during this period. 1259 (3.1%) demonstrated the EF-ILA pattern (mean±sd age 65.4±7.32 years; 735 (47.8%) male). EF-ILA was significantly associated with all-cause mortality (hazard ratio 1.87, 95% CI 1.25–2.78; p=0.002). 362 cases underwent at least one follow-on CT. Radiological progression was observed in 157 (43.4%) cases: increase in reticulation n=51, new traction bronchiectasis n=84, honeycombing n=22. Monocyte count, neutrophil count, monocyte:lymphocyte ratio, neutrophil:lymphocyte ratio and “systemic inflammatory response index” were significantly associated with radiological progression. Conclusion 3.1% of subjects requiring thoracic CT during a 6-year period demonstrated EF-ILA. Monocyte levels and blood leukocyte-derived indexes were associated with radiological progression and could indicate which patients may require closer follow-up.http://openres.ersjournals.com/content/8/3/00226-2022.full |
| spellingShingle | Andrew Achaiah Paul Lyon Emily Fraser Peter Saunders Rachel Hoyles Rachel Benamore Ling-Pei Ho Increased monocyte level is a risk factor for radiological progression in patients with early fibrotic interstitial lung abnormality ERJ Open Research |
| title | Increased monocyte level is a risk factor for radiological progression in patients with early fibrotic interstitial lung abnormality |
| title_full | Increased monocyte level is a risk factor for radiological progression in patients with early fibrotic interstitial lung abnormality |
| title_fullStr | Increased monocyte level is a risk factor for radiological progression in patients with early fibrotic interstitial lung abnormality |
| title_full_unstemmed | Increased monocyte level is a risk factor for radiological progression in patients with early fibrotic interstitial lung abnormality |
| title_short | Increased monocyte level is a risk factor for radiological progression in patients with early fibrotic interstitial lung abnormality |
| title_sort | increased monocyte level is a risk factor for radiological progression in patients with early fibrotic interstitial lung abnormality |
| url | http://openres.ersjournals.com/content/8/3/00226-2022.full |
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