Blood monocyte counts as a prognostic biomarker and predictor in Chinese patients with idiopathic pulmonary fibrosis

Xinran Zhang; Yanhong Ren; Bingbing Xie; Qiao Ye; Chenjun Ban; Shu Zhang; Min Zhu; Yan Liu; Shiyao Wang; Jing Geng; Xuan He; Dingyuan Jiang; Jiarui He; Shi Shu; Sa Luo; Xin Wang; Dingyun Song; Mingming Fan; Haishuang Sun; Huaping Dai

doi:10.3389/fmed.2022.955125

Blood monocyte counts as a prognostic biomarker and predictor in Chinese patients with idiopathic pulmonary fibrosis

Front Med (Lausanne). 2022 Nov 8:9:955125. doi: 10.3389/fmed.2022.955125. eCollection 2022.

Authors

Xinran Zhang^{1

2

3

4}, Yanhong Ren^{2

4

5

6}, Bingbing Xie^{2

4

5

6}, Qiao Ye⁷, Chenjun Ban⁸, Shu Zhang⁷, Min Zhu⁷, Yan Liu⁷, Shiyao Wang^{2

4

5

6}, Jing Geng^{2

4

5

6}, Xuan He^{2

4

5

6}, Dingyuan Jiang^{2

4

5

6}, Jiarui He^{2

4

5

6}, Shi Shu^{2

4

5

6}, Sa Luo^{2

4

5

6}, Xin Wang^{2

4

5

6

9}, Dingyun Song^{2

4

5

6}, Mingming Fan^{2

4

5

6

10}, Haishuang Sun^{2

4

5

6

11}, Huaping Dai^{2

4

5

6

7}

Affiliations

¹ Department of Clinical Research and Data Management, Center of Respiratory Medicine, China-Japan Friendship Hospital, Beijing, China.
² National Center for Respiratory Medicine, Beijing, China.
³ Institute of Respiratory Medicine, Chinese Academy of Medical Sciences, Beijing, China.
⁴ National Clinical Research Center for Respiratory Diseases, Beijing, China.
⁵ Department of Pulmonary and Critical Care Medicine, Center of Respiratory Medicine, China-Japan Friendship Hospital, Beijing, China.
⁶ Institute of Respiratory Medicine, Peking Union Medical College, Chinese Academy of Medical Science, Beijing, China.
⁷ Department of Pulmonary and Critical Care Medicine, Beijing Chao-Yang Hospital, Capital Medical University, Beijing, China.
⁸ Department of Respiration, Dongzhimen Hospital, Beijing University of Chinese Medicine, Beijing, China.
⁹ Beijing University of Chinese Medicine, Beijing, China.
¹⁰ The Second Hospital of Jilin University, Changchun, China.
¹¹ The First Hospital of Jilin University, Changchun, China.

Abstract

Objectives: We sought to evaluate the prognostic value of blood routine parameters and biochemical parameters, especially inflammation-related biomarkers, and establish an inflammation-related prognostic model in Chinese patients with idiopathic pulmonary fibrosis (IPF).

Material/methods: Patients diagnosed as IPF at Beijing Chaoyang Hospital and aged 40 years and older were consecutively enrolled from June 2000 to March 2015, and finally, a total of 377 patients were enrolled in the derivation cohort. The follow-up ended in December 2016. We used Cox proportional hazard model to calculate the hazard ratio (HR) and establish the prognostic model. The discrimination and calibration of the prognostic model were evaluated in an independent validation cohort enrolled from China-Japan Friendship Hospital between January 2015 and December 2019.

Results: Multivariate analysis revealed that patients with elevated monocyte-to-red blood cell count ratio (MRR) and monocyte counts showed increased risk of mortality. The clinical-physiological-biomarker (CPB) index and CPB stage we established in this study were a significant predictor, and the C-index for CPB index and CPB stage in the validation cohort was 0.635 (95% CI: 0.558-0.712) and 0.619 (95% CI: 0.544-0.694), respectively. Patients in CPB stage III had the poorest survival.

Conclusion: We developed and validated a new inflammation-related prognostic model (CPB index and CPB stage) which was integration of age, gender, FVC (%, predicted), DLCO (%, predicted), Charlson Comorbidity Index, and blood monocyte counts. This prediction model exhibited strong ability in predicting mortality in Chinese patients with IPF.

Keywords: biomarker; idiopathic pulmonary fibrosis; monocyte counts; predict model; prognosis.