engleski

Differential diagnosis of interstital lung diseases based on morphometry of macrophage nuclei in BAL

Introduction or background: Interstitial lung disease (ILD) includes a variety of clinical disorders with different origin. In the differential di¬agnosis of the interstitial pulmonary disorders, sarcoidosis, hypersensitivity pneumonitis, collagen vascular diseases, idiopathic pulmonary fibrosis (IPF) and bronchiolitis obliterans organising pneumonitis (BOOP) are the most common and responsible for about two thirds of all cases. Aim of the study: . Lymphocyte in¬crease in differential lung lavage cell count is helpful in differential diagnosis of ILD-s, but macrophages represent the largest cell population ob¬tained by BAL from the lungs of patients with the most ILD-s. Morphometric and image cytometric DNA analysis of the macrophages nuclei in BAL fluid of patients with interstitial lung diseases have been investigated in order to establish their diagnostic and clinical significance. Methods: Investigated morphometric parameters were: area, outline, convex area, length, breadth, maximal radius, minimal radius, form factor (FF), elongation factor (EF), area/convex area (ACA), DNA index (DI), percentage of cells before histogram peak, percentage of cells in peak, percentage of cells after histogram peak, percentage of cells in S-phase and G2M phase. Seventy-three patients were included in the investigation, separated in five groups: hypersensitivity pneumonitis (n=18), sarcoidosis with acute onset (n=16), sarcoidosis with chronic onset (n=17), other interstitial lung diseases (n=12) and controls (n=10). Results: Statistical significant differences were observed between groups in all statistical descriptions of morphomeric parameters area, outline, convex area, length and maximal radius of the macrophages nuclei in BAL fluid (p<0, 05) and the percentage of the cells in S-phase between all five groups. Multivatiate discriminant backward step-wise analysis resulted in classification functions of 43 variables of morphometric and DNA cytometric parameters of macrophages nuclei in BAL fuid allowing separation groups of patients with hypersensitivity pneumonitis, sarcoidosis with acute onset, sarcoidosis with chronic onset, other interstitial lung diseases and controls without lung disease.

ILD; BAL; morphometry; macrophages;

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