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. 2024 Jan 5;24(1):16.
doi: 10.1186/s12890-023-02833-6.

ILD-GAP combined with the monocyte ratio could be a better prognostic prediction model than ILD-GAP in patients with interstitial lung diseases

Momo Hirata  1 , Yu Hara  2 , Hiroaki Fujii  1 , Kota Murohashi  1 , Yusuke Saigusa  3 , Shiqi Zhao  3 , Miyu Kobayashi  3 , Ryo Nagasawa  1 , Yoichi Tagami  1 , Ami Izawa  1 , Yukiko Otsu  1 , Keisuke Watanabe  1 , Nobuyuki Horita  1 , Nobuaki Kobayashi  1 , Takeshi Kaneko  1
Affiliations

ILD-GAP combined with the monocyte ratio could be a better prognostic prediction model than ILD-GAP in patients with interstitial lung diseases

Momo Hirata et al. BMC Pulm Med. .

Abstract

Background: The ILD-GAP scoring system is known to be useful in predicting prognosis in patients with interstitial lung disease (ILD). An elevated monocyte count was associated with increased risks of IPF poor prognosis. We examined whether the ILD-GAP scoring system combined with the monocyte ratio (ILD-GAPM) is superior to the conventional ILD-GAP model in predicting ILD prognosis.

Methods: In patients with ILD treated between April 2013 and April 2017, we were retrospectively assessed the relationships between baseline clinical parameters, including age, sex, Charlson Comorbidity Index score (CCIS), ILD diagnosis, blood biomarkers, pulmonary function test results, and disease outcomes. In ILD patients were included idiopathic pulmonary fibrosis (IPF), idiopathic nonspecific interstitial pneumonia (iNSIP), collagen vascular disease-related interstitial pneumonia (CVD-IP), chronic hypersensitivity pneumonitis (CHP), and unclassifiable ILD (UC-ILD). We also assessed the ability to predict prognosis was compared between the ILD-GAP and ILD-GAPM models.

Results: A total of 179 patients (mean age, 73 years) were assessed. All of them were taken pulmonary function test, including percentage predicted diffusion capacity for carbon monoxide. ILD patients included 56 IPF cases, 112 iNSIP and CVD-IP cases, 6 CHP cases and 5 UC-ILD cases. ILD-GAPM provided a greater area under the receiver-operating characteristic curve (0.747) than ILD-GAP (0.710) for predicting 3-year ILD-related events. Furthermore, the log-rank test showed that the Kaplan-Meier curves in ILD-GAPM were significantly different by stage (P = 0.015), but not by stage in ILD-GAP (P = 0.074).

Conclusions: The ILD-GAPM model may be a more accurate predictor of prognosis for ILD patients than the ILD-GAP model.

Keywords: Composite scoring system; Diffusion capacity of lung for carbon monoxide; Idiopathic pulmonary fibrosis; Interstitial lung disease; Monocyte ratio.

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Conflict of interest statement

The authors declare no competing interests.

Figures

Fig. 1
Fig. 1
Flowchart of the participant selection process. Abbreviations: CVD-IP, collagen vascular disease-related interstitial pneumonia; ILD, interstitial lung disease; iNSIP, idiopathic NSIP
Fig. 2
Fig. 2
Survival curves of the patients with IPF and non-IPF according to peripheral blood monocyte ratio. A All patients (N = 179); (B) IPF patients (N = 56); (C) Non-IPF patients (N = 123). Abbrevialtions: IPF, idiopathic pulmonary fibrosis
Fig. 3
Fig. 3
Survival curves of the patients with IPF and non-IPF with or without honeycomb. A All patients (N = 179); (B) IPF patients (N = 56); (C) Non-IPF patients (N = 123). Abbrevialtions: IPF, idiopathic pulmonary fibrosis
Fig. 4
Fig. 4
Survival curves of ILD-GAP and ILD-GAPM models. A ILD-GAP model; (B) ILD-GAPM model; (C) ILD-GAP model for the patients with < 90% DLco; (D) ILD-GAP model for the patients with < 90% DLco (red line, ILD-GAPM stage I; green line, stage II; blue line, stage ≥III). Abbrevialtions: GAP, gender / age / physiology; GAPM, gender / age / physiology / blood monocyte ratio; ILD, interstitial lung disease
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