Relationship of flow-volume curve pattern on pulmonary function test with clinical and radiological features in idiopathic pulmonary fibrosis.

Background:The flow-volume (FV) curve pattern in the pulmonary function test (PFT) for obstructive lung diseases is widely recognized. However, there are few reports on FV curve pattern in idiopathic pulmonary fibrosis (IPF). In this study, we investigated the relationship between FV curve pattern and clinical or radiological features in IPF.Methods:The FV curves on PFTs and chest high-resolution computed tomography (HRCT) images of 130 patients with IPF were retrospectively evaluated. The FV curves were divided into four groups based on the presence or absence of the convex and concave patterns: convex/concave, non-convex/concave, convex/non-concave, and non-convex/non-concave. Using a computer-aided system, CT honeycombing area (%HA) and subtracted low attenuation area (%sLAA) were quantitatively measured. To assess the distribution of CT findings, the lung area was divided into upper, lower, central, and peripheral areas. The relationships of FV curve patterns with patient characteristics, spirometry results, and quantitative CT findings were evaluated.Results:The patients with convex pattern was identified in 93 (71.5%) and concave pattern in 72 (55.4%). Among the four groups, patients with the convex/non-concave pattern had significantly lower forced vital capacity (FVC) and higher %HA of the upper/peripheral lung area (p = 0.018, and p = 0.005, respectively). The convex/non-concave pattern was a significant predictor of mortality for IPF (hazard ratio, 2.19; p = 0.032).Conclusions:Patients with convex/non-concave pattern in FV curve have lower FVC and poorer prognosis with distinct distribution of fibrosis. Hence, FV curve pattern might be a useful predictor of mortality in IPF

Mechanisms of primary and acquired resistance to immune checkpoint inhibitors in advanced non-small cell lung cancer: a multiplex immunohistochemistry-based single-cell analysis

近畿大学Kindai University博士（医学）主査：宮澤正顯 教授　　学内授与番号：医第1390号 Kohsuke Isomoto, Koji Haratani, Takahiro Tsujikawa, Yusuke Makutani, Hisato Kawakami, Masayuki Takeda, Kimio Yonesaka, Kaoru Tanaka, Tsutomu Iwasa, Hidetoshi Hayashi, Akihiko Ito, Kazuto Nishio, Kazuhiko Nakagawa ”Mechanisms of primary and acquired resistance to immune checkpoint inhibitors in advanced non–small cell lung cancer: a multiplex immunohistochemistry–based single-cell analysis”Lung Cancer, Volume 174, December 2022, Pages 71-82 https://doi.org/10.1016/j.lungcan.2022.10.012 掲載doctoral thesi

Mechanisms of primary and acquired resistance to immune checkpoint inhibitors in advanced non-small cell lung cancer: a multiplex immunohistochemistry-based single-cell analysis

主査：宮澤正顯 教授　　学内授与番号：医第1390号 Kohsuke Isomoto, Koji Haratani, Takahiro Tsujikawa, Yusuke Makutani, Hisato Kawakami, Masayuki Takeda, Kimio Yonesaka, Kaoru Tanaka, Tsutomu Iwasa, Hidetoshi Hayashi, Akihiko Ito, Kazuto Nishio, Kazuhiko Nakagawa ”Mechanisms of primary and acquired resistance to immune checkpoint inhibitors in advanced non–small cell lung cancer: a multiplex immunohistochemistry–based single-cell analysis”Lung Cancer, Volume 174, December 2022, Pages 71-82 https://doi.org/10.1016/j.lungcan.2022.10.012 掲

Anti-Ku antibody-positive desquamative interstitial pneumonia

A 66-year-old man, an ex-smoker, was referred to our hospital for slightly progressive respiratory symptoms of cough and dyspnea on exertion and chest abnormal shadow. Chest high-resolution computed tomography showed wide-ranging ground-glass attenuation and reticulation with lower lobe predominance. Bronchoalveolar lavage (BAL) fluid revealed a marked increase in lymphocytes (53.0%), and a surgical lung biopsy revealed a pattern of desquamative interstitial pneumonia (DIP) with hyperplasia of the lymphoid follicles. His serum was positive for anti-Ku and anti-SS-A antibodies, and he had signs (such as Raynaud's phenomenon, joint pain, and mechanic's hand) suspicious of connective tissue disease (CTD) although a definitive diagnosis of CTD had not been established. On the basis of the findings in our patient obtained from the serologic domain, BAL, and pathological examination, clinicians should consider the important correlation of DIP with CTD as well as with smoking. Keywords: Desquamative interstitial pneumonia, Anti-Ku antibody, Connective tissue diseas