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The role of lung biopsy for diagnosis and prognosis of interstitial lung disease in systemic sclerosis: a systematic literature review.
Damiani, A; Orlandi, M; Bruni, C; Bandini, G; Lepri, G; Scaletti, C; Ravaglia, C; Frassanito, F; Guiducci, S; Moggi-Pignone, A; Matucci-Cerinic, M; Poletti, V; Tofani, L; Colby, T V; Randone, S Bellando; Tomassetti, Sara.
Afiliación
  • Damiani A; Department of Clinical and Experimental Medicine, Rheumatology Unit, University of Florence, Careggi University Hospital, Florence, Italy.
  • Orlandi M; Department of Clinical and Experimental Medicine, Rheumatology Unit, University of Florence, Careggi University Hospital, Florence, Italy.
  • Bruni C; Department of Medical and Surgical for Children and Adults, Modena, Italy.
  • Bandini G; Department of Clinical and Experimental Medicine, Rheumatology Unit, University of Florence, Careggi University Hospital, Florence, Italy.
  • Lepri G; Department of Experimental and Clinical Medicine, Division of Internal Medicine, University of Florence, Careggi University Hospital, Florence, Italy.
  • Scaletti C; Department of Clinical and Experimental Medicine, Rheumatology Unit, University of Florence, Careggi University Hospital, Florence, Italy.
  • Ravaglia C; Department of Clinical and Experimental Medicine, Rheumatology Unit, University of Florence, Careggi University Hospital, Florence, Italy.
  • Frassanito F; Pulmonary Unit, Department of Thoracic Diseases, Azienda USL Romagna, GB Morgagni-L-Pierantoni Hospital, Bologna University, Forlì, Italy.
  • Guiducci S; Department of Clinical and Experimental Medicine, Rheumatology Unit, University of Florence, Careggi University Hospital, Florence, Italy.
  • Moggi-Pignone A; Department of Clinical and Experimental Medicine, Rheumatology Unit, University of Florence, Careggi University Hospital, Florence, Italy.
  • Matucci-Cerinic M; Department of Experimental and Clinical Medicine, Division of Internal Medicine, University of Florence, Careggi University Hospital, Florence, Italy.
  • Poletti V; Department of Clinical and Experimental Medicine, Rheumatology Unit, University of Florence, Careggi University Hospital, Florence, Italy.
  • Tofani L; Unit of Immunology, Rheumatology, Allergy and Rare diseases (UnIRAR), IRCCS San Raffaele Hospital, Milan, Italy.
  • Colby TV; Pulmonary Unit, Department of Thoracic Diseases, Azienda USL Romagna, GB Morgagni-L-Pierantoni Hospital, Bologna University, Forlì, Italy.
  • Randone SB; Department of Statistics, Informatics and Applications, University of Florence, Florence, Italy.
  • Tomassetti S; Department of Pathology and Laboratory Medicine (Emeritus), Mayo Clinic, Scottsdale, AZ, 13400, USA.
Respir Res ; 25(1): 138, 2024 Mar 23.
Article en En | MEDLINE | ID: mdl-38521926
ABSTRACT

BACKGROUND:

The prognostic and theragnostic role of histopathological subsets in systemic sclerosis interstitial lung disease (SSc-ILD) have been largely neglected due to the paucity of treatment options and the risks associated with surgical lung biopsy. The novel drugs for the treatment of ILDs and the availability of transbronchial cryobiopsy provide a new clinical scenario making lung biopsy more feasible and a pivotal guide for treatment. The aim of our study was to investigate the usefulness of lung biopsy in SSc ILD with a systematic literature review (SLR).

METHODS:

PubMed, Embase and Cochrane databases were searched up to June 30, 2023. Search terms included both database-specific controlled vocabulary terms and free-text terms relating to lung biopsy and SSc-ILD diagnostic and prognosis. The SLR was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-analysis (PRISMA). Studies were selected according to the PEO (population, exposure, and outcomes) framework and Quality assessment of diagnostic accuracy studies (QUADAS) were reported.

RESULTS:

We selected 14 articles (comprising 364 SSc-ILD patients). The paucity and heterogeneity of the studies prevented a systematic analysis. Diffuse cutaneous SSc was present in 30-100% of cases. Female predominance was observed in all studies (ranging from 64 to 100%). Mean age ranged from 42 to 64 years. Mean FVC was 73.98 (+/-17.3), mean DLCO was 59.49 (+/-16.1). Anti-Scl70 antibodies positivity was detected in 33% of cases (range 0-69.6). All patients underwent surgical lung biopsies, and multiple lobes were biopsied in a minority of studies (4/14). Poor HRCT-pathologic correlation was reported with HRCT-NSIP showing histopathologic UIP in up to 1/3 of cases. Limited data suggest that SSc-UIP patients may have a worse prognosis and response to immunosuppressive treatment compared to other histopathologic patterns.

CONCLUSIONS:

The data from this SLR clearly show the paucity and heterogeneity of the studies reporting lung biopsy in SSc ILD. Moreover, they highlight the need for further research to address whether the lung biopsy can be helpful to refine prognostic prediction and guide therapeutic choices.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Esclerodermia Sistémica / Enfermedades Pulmonares Intersticiales / Pulmón Límite: Female / Humans Idioma: En Revista: Respir Res Año: 2024 Tipo del documento: Article País de afiliación: Italia Pais de publicación: Reino Unido
Texto completo
Añadir a Mi BVS
Imprimir
XML
PubMed Links
Buscar en Google

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Esclerodermia Sistémica / Enfermedades Pulmonares Intersticiales / Pulmón Límite: Female / Humans Idioma: En Revista: Respir Res Año: 2024 Tipo del documento: Article País de afiliación: Italia Pais de publicación: Reino Unido