OBJECTIVE To examine changes in the extent of specific patterns of interstitial lung disease (ILD) as they transition from one pattern to another in response to immunosuppressive therapy in systemic sclerosis-related ILD (SSc-ILD). METHODS We evaluated changes in the quantitative extent of specific lung patterns of ILD using volumetric high-resolution computed tomography (HRCT) scans obtained at baseline and after 2 years of therapy in patients treated with either cyclophosphamide (CYC) for 1 year or mycophenolate mofetil (MMF) for 2 years in Scleroderma Lung Study II. ILD patterns included lung fibrosis, ground glass, honeycombing, and normal lung. Net change was calculated as the difference in the probability of change from one ILD pattern to another. Wilcoxon's signed rank test was used to compare the changes. RESULTS Forty-seven and 50 patients had baseline and follow-up scans in the CYC and MMF groups, respectively. Mean net improvements reflecting favorable changes from one ILD pattern to another in the whole lung in the CYC and MMF groups, respectively, were as follows: from lung fibrosis to a normal lung pattern, 21% and 19%; from a ground-glass pattern to a normal lung pattern, 30% and 28%; and from lung fibrosis to a ground-glass pattern, 5% and 0.5%. The mean overall improvement in transitioning from a ground-glass pattern or lung fibrosis to a normal lung pattern was significant for both treatments (all P < 0.001). CONCLUSION Significantly favorable transitions from both ground-glass and lung fibrosis ILD patterns to a normal lung pattern were observed in patients undergoing immunosuppressive treatment for SSc-ILD, suggesting the usefulness of examining these transitions for insights into the underlying pathobiology of treatment response.

中文翻译：

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使用高分辨率计算机断层扫描上的过渡变化来监测环磷酰胺或霉酚酸酯对系统性硬化症相关性间质性肺疾病的影响。

目的探讨间质性肺疾病（ILD）特定模式的范围变化，这些变化是由于系统性硬化相关ILD（SSc-ILD）的免疫抑制治疗而从一种模式转变为另一种模式。方法我们使用在基线和治疗2年后接受环磷酰胺（CYC）治疗1年或霉酚酸酯（Mocotiltil Mofetil）治疗的患者，在基线和治疗2年后使用体积高分辨率计算机断层扫描（HRCT）扫描，评估了ILD特定肺型的定量范围的变化MMF）在硬皮病肺病研究II中持续2年。ILD模式包括肺纤维化，毛玻璃，蜂窝状和正常肺。净变化被计算为从一种ILD模式到另一种ILD模式的变化概率之差。Wilcoxon的符号秩检验用于比较更改。结果CYC和MMF组分别有47例和50例患者进行了基线和随访扫描。CYC组和MMF组的平均净改善分别反映了CYC和MMF组从一种ILD模式到另一种肺的有利变化：从肺纤维化到正常肺模式，分别为21％和19％；从毛玻璃样到正常肺样分别为30％和28％；从肺纤维化到毛玻璃样，分别为5％和0.5％。对于两种治疗，从毛玻璃样转变或肺纤维化转变为正常肺样的平均总体改善是显着的（所有P <0.001）。结论在接受SSc-ILD免疫抑制治疗的患者中，观察到从毛玻璃样和肺纤维化ILD模式到正常肺模式的明显有利转变，