Background

Sarcoidosis is associated with a wide range of disease outcomes including spontaneous remission and progressive courses. It is necessary to identify patients with spontaneous remission without corticosteroid treatment. This study aimed to identify the markers for predicting spontaneous remission in patients with sarcoidosis.

Methods

453 patients diagnosed with sarcoidosis at the Shanghai Pulmonary Hospital between Jan 2013 and Aug 2017 and were followed-up for more than 2 years were enrolled. Patients were divided into spontaneous remission group and non-remission group. Differences of variables between groups were analyzed by chi-square test or unpaired Student's t-test. The cumulative spontaneous remission rate was analyzed using the Kaplan-Meier method.

Results

Of the 173 patients (stage I/II/III/IV, 53/110/6/4) without medication, 117 (67.6%) achieved spontaneous remission. The serum level of soluble interleukin-2 (IL-2) receptor (sIL-2R) and the ratio of CD4/CD8 was significantly lower and CD8⁺ T cell was significantly higher in spontaneous remission group when compared with non-remission group (P < 0.001, P = 0.042 and P = 0.048). Multivariate logistic regression model showed sIL-2R level was an independent predictor of spontaneous remission (P = 0.021). In stage I subgroup, a cut-off value of 1129.5U/ml was obtained from the ROC curve, which yielded a sensitivity of 50% and a specificity of 94.4%. In stage II subgroup, a cut-off value of 1026.5U/ml was obtained with a sensitivity of 66.7% and a specificity of 68.7%.

Conclusion

This study provided useful information that sIL-2R level could be used as a maker for spontaneous remission in determining the treatment strategies for patients with pulmonary sarcoidosis.

中文翻译：

---

sIL-2R水平可预测结节病的自发缓解。

背景

结节病与多种疾病结局有关，包括自发缓解和进行性病程。有必要确定未经皮质类固醇治疗可自发缓解的患者。这项研究旨在确定预测结节病患者自发缓解的标志物。

方法

纳入2013年1月至2017年8月间在上海肺科医院诊断为结节病的453例患者，随访时间超过2年。患者分为自发缓解组和非缓解组。组间变量的差异通过卡方检验或不成对的学生t检验进行分析。使用Kaplan-Meier方法分析累积自发缓解率。

结果

在没有药物治疗的173例患者（I / II / III / IV期，53/110/6/4）中，有117例（67.6％）实现了自发缓解。与非缓解组相比，自发缓解组的血清可溶性白介素2（IL-2）受体水平（sIL-2R）和CD4 / CD8比值显着降低，而CD8 ⁺ T细胞显着高于非缓解组（P  <0.001，P  = 0.042和P  = 0.048）。多因素Logistic回归模型显示sIL-2R水平是自发缓解的独立预测因子（P = 0.021）。在I期亚组中，从ROC曲线获得的临界值为1129.5U / ml，灵敏度为50％，特异性为94.4％。在第二阶段亚组中，获得的临界值为1026.5U / ml，敏感性为66.7％，特异性为68.7％。

结论

这项研究提供了有用的信息，即在确定肺结节病患者的治疗策略时，sIL-2R水平可作为自发缓解的机制。