Exploring The Correlation Between Connective Tissue Disease Associated With Interstitial Lung Disease And Anti-Ro52 Antibody From The Perspective Of "Stasis Blocking Lung Collaterals"

Objective:To analyze the differences of anti-Ro52 antibody in connective tissue disease(CTD)and connective tissue disease associated with interstitial lung disease(CTD-ILD),explore the relationship between anti-Ro52 antibody and CTD-ILD,and analyze the correlation between anti-Ro52 antibody and phlegm-stasis obstructing lung syndrome in CTD-ILD based on "stasis blocking lung collaterals".Methods:Inpatients including rheumatoid arthritis(RA),sjogren’s syndrome(SS),polymyositis/dermatomyositis(PM/DM)and associated with ILD(RA-ILD,SS-ILD,DM/PM-ILD)were selected in the Department of Lung Diseases and Department of Rheumatology,affiliated Hospital of Shandong University of Traditional Chinese Medicine,from January 2016 to December 2017.The data of age,sex,anti-Ro52 antibody,ANA spectrum,ESR,CRP,ANA quantification,tumor markers and TCM syndrome types were collected from 1 54 inpatients with CTD and 100 inpatients with CTD-ILD.Then retrospectively analyzed the differences of the above data between CTD and CTD-ILD,the correlation between anti-Ro52 antibody and other indexes,the risk factors of CTD-ILD,the diagnostic value of anti-Ro52 antibody and the correlation between anti-Ro52 antibody and TCM syndrome types.Results:1.the positive rates of anti-Ro52 antibody and anti-Jo-1 antibody in the CTD-ILD group were significantly higher than those in the CTD group,and there were very significant differences between the two groups(P<0.01).The age,CEA,CA199,CA125 and CA153 in CTD-ILD group were significantly higher than those in CTD group,and there were very significant differences between the two groups.Ferritin in CTD-ILD group was higher than that in CTD group,and there was a significant difference between the two groups.2.The positive rate of anti-Ro52 antibody in PM/DM-ILD group was higher than that in RA-ILD group,and there was a significant difference between the two groups(P<0.01).3.There was no significant difference in the positive rate of anti-Ro52 antibody and anti-Jo-1 antibody between RA group and RA-ILD group(P>0.05).There was no significant difference in the positive rate of anti-Ro52 antibody and anti-Jo-1 antibody between SS group and SS-ILD group.The positive rate of anti-Ro52 antibody and anti-Jo-1 antibody in PM/DM-ILD group was significantly higher than that in PM/DM group.4.Age,anti-Ro52 antibody,CEA,CA125,CA153,CA199 and ferritin were the risk factors of CTD-ILD,while anti-Ro52 antibody,CA125 and CA153 were independent risk factors of CTD-ILD.Age,anti-Ro52 antibody,CEA,CA125 and CA153 were risk factors of PM/DM-ILD,while anti-Ro52 antibody,CA125 and CA153 were independent risk factors of PM/DM-ILD.5.The area under the ROC curve of anti-Ro52 antibody in the diagnosis of CTD-ILD and PM/DM-ILD were 0.628 and 0.769 respectively,which had low and moderate diagnostic value for CTD-ILD and PM/DM-ILD,respectively.6.The factors related to anti-Ro52 antibody were anti-Jo-1 antibody,CEA,CA153 and ferritin,which were significantly positively and weakly correlated with anti-Ro52 antibody.7.There was a significant difference in the positive rate of anti-Ro52 antibody among the five syndrome types of CTD-ILD patients.The positive rate of anti-Ro52 antibody in the syndrome of phlegm-stasis blocking the lung was significantly higher than that of the other four syndromes,and there was a significant difference between the syndrome of phlegm-stasis blocking the lung and the syndrome of cold-dampness blocking the lung.Conclusion:1.The possible risk factors of ILD-CTD are age,anti-Ro52 antibody,CEA,CA125,CA153,CA199 and ferritin.2.Anti-Ro52 antibody can be used as an early risk assessment index for PM/DM-ILD,which is helpful to the clinical diagnosis of PM/DM-ILD.3.The TCM syndrome types of CTD-ILD mainly are phlegm-stasis blocking lung syndrome and phlegm-heat blocking lung syndrome.Blood stasis and turbid phlegm may be the main pathological factors of CTD-ILD.