基线和周围血液转录组的变化提高了纤维化过敏性肺炎的结果预测:一个前性的多中心队列研究
Evans R Fernández Pérez1, Sonia M Leach2, Stephen M Humphries3
1Division of Pulmonary, Critical Care and Sleep Medicine, National Jewish Health, Denver, CO.
medRxiv : the preprint server for health sciences
|November 26, 2025
概括
周围血液单核细胞 (PBMC) 基因表达特征可以预测纤维过敏性肺炎 (fHP) 患者的疾病进展. 将基因表达与临床因素相结合,与单独临床因素相比,可显著改善预后模型.
科学领域:
- 肺部医学 肺部医学
- 基因组学就是基因组学.
- 翻译研究是翻译研究.
背景情况:
- 关于外围血液单核细胞 (PBMC) 表达特征在预测纤维过敏性肺炎 (fHP) 患者疾病进展中的预后价值的数据有限.
- 目前对fHP进展的临床评估缺乏全面的预测准确性.
研究的目的:
- 为了确定fHP患者的PBMC中的转录组签名是否可以提高无进展生存 (PFS) 预测.
- 评估基因表达特征是否可以补充fHP现有的临床风险分层.
主要方法:
- 一项前性多中心研究,涉及133名fHP参与者.
- 拉索回归开发基线和12个月的变化基因签名从PBMC转录组学.
- 使用ROC曲线评估了具有和没有基因表达特征的结合临床变量 (年龄,性别,吸烟,暴露,FVC%,DTA) 的多变量模型.
主要成果:
- 包括基因表达的基线改善了24个月PFS预测AUC从0.77到0.93.
- 包括12个月的基因表达变化改善了12个月的PFS预测AUC从0.81到0.95.
- 较高的基线和12个月的基因表达得分与明显较低的无进展生存率相关 (P < 0.001).
结论:
- 周围血液中的风险指示性基因表达特征预测fHP疾病的进展.
- 12个月内基因表达的变化也预测了随后的疾病进展.
- 综合基因表达和临床因素的预后模型显著优于仅基于临床因素的预后模型.
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