A noval identification of 4 systemic sclerosis - interstitial lung disease subgroups using principal component analysis-based cluster analysis

Abstract Objective Interstitial lung disease (ILD) is a common and serious complication of systemic sclerosis (SSc). It is usually classified by histologic type, but this classification may not fully reflect the clinical phenotypic variation. This study aimed to examine clinical features and aggrega...

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Main Authors: Yaqi Zhao, Baoting Chao, Wei Xu, Xinya Li, Jin Zhang, Ying Zhang, Zhenzhen Ma, Qingrui Yang
Format: Article
Language:English
Published: BMC 2025-05-01
Series:BMC Pulmonary Medicine
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Online Access:https://doi.org/10.1186/s12890-025-03722-w
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author Yaqi Zhao
Baoting Chao
Wei Xu
Xinya Li
Jin Zhang
Ying Zhang
Zhenzhen Ma
Qingrui Yang
author_facet Yaqi Zhao
Baoting Chao
Wei Xu
Xinya Li
Jin Zhang
Ying Zhang
Zhenzhen Ma
Qingrui Yang
author_sort Yaqi Zhao
collection DOAJ
description Abstract Objective Interstitial lung disease (ILD) is a common and serious complication of systemic sclerosis (SSc). It is usually classified by histologic type, but this classification may not fully reflect the clinical phenotypic variation. This study aimed to examine clinical features and aggregate patients with SSc-ILD based on patients’ clinical manifestations, High-resolution computed tomography (HRCT) features and specific antibody expression to achieve precise treatment of SSc-ILD with early identification of complications. Methods This study included 103 patients with SSc-ILD. A cluster analysis was performed based on five clinical and serological variables to identify subgroups of patients. The survival rates between obtained clusters and risk factors affecting prognosis were also compared. Result Four clusters were identified in this study: Cluster 1 (n = 23) represented the lymphocytic interstitial pneumonia (LIP) group with LIP as the predominant HRCT characteristic. Cluster 2 (n = 23) was the worst prognosis group, with the highest Warrick score as well as the highest mortality rate. Cluster 3 (n = 20) with all patients having a negative anti-SCL-70 antibody response. Cluster 4 (n = 28) with all patients were positive for the anti-SCL-70 antibody. It was found that albumin was a protective factor for the prognosis of patients with SSC-ILD patients (p = 0.018), whereas age (p = 0.036) and IgM (p = 0.040) were risk factors. Conclusion The results of our cluster analysis indicated that based solely on histologic typing, may not be capturing the full heterogeneity of SSc-ILD patients. In order to identify homogeneous patient groups with a specific prognosis, HRCT features and antibody profiles should be taken into consideration.
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spelling doaj-art-a5f217e7c7d848bba8a1c792e38741ad2025-08-20T02:33:31ZengBMCBMC Pulmonary Medicine1471-24662025-05-0125111410.1186/s12890-025-03722-wA noval identification of 4 systemic sclerosis - interstitial lung disease subgroups using principal component analysis-based cluster analysisYaqi Zhao0Baoting Chao1Wei Xu2Xinya Li3Jin Zhang4Ying Zhang5Zhenzhen Ma6Qingrui Yang7Department of Rheumatology and Immunology, Cheeloo College of Medicine, Shandong Provincial Hospital, Shandong UniversityDepartment of Radiology, Shandong Provincial Hospital Affiliated to Shandong First Medical UniversityDepartment of Rheumatology and Immunology, Cheeloo College of Medicine, Shandong Provincial Hospital, Shandong UniversityDepartment of Rheumatology and Immunology, Shandong Provincial Hospital Affiliated to Shandong First Medical UniversityDepartment of Rheumatology and Immunology, Shandong Provincial Hospital Affiliated to Shandong First Medical UniversityDepartment of Rheumatology and Immunology, Shandong Provincial Hospital Affiliated to Shandong First Medical UniversityThe First Clinical Medical College, Shandong University of Traditional Chinese MedicineDepartment of Rheumatology and Immunology, Cheeloo College of Medicine, Shandong Provincial Hospital, Shandong UniversityAbstract Objective Interstitial lung disease (ILD) is a common and serious complication of systemic sclerosis (SSc). It is usually classified by histologic type, but this classification may not fully reflect the clinical phenotypic variation. This study aimed to examine clinical features and aggregate patients with SSc-ILD based on patients’ clinical manifestations, High-resolution computed tomography (HRCT) features and specific antibody expression to achieve precise treatment of SSc-ILD with early identification of complications. Methods This study included 103 patients with SSc-ILD. A cluster analysis was performed based on five clinical and serological variables to identify subgroups of patients. The survival rates between obtained clusters and risk factors affecting prognosis were also compared. Result Four clusters were identified in this study: Cluster 1 (n = 23) represented the lymphocytic interstitial pneumonia (LIP) group with LIP as the predominant HRCT characteristic. Cluster 2 (n = 23) was the worst prognosis group, with the highest Warrick score as well as the highest mortality rate. Cluster 3 (n = 20) with all patients having a negative anti-SCL-70 antibody response. Cluster 4 (n = 28) with all patients were positive for the anti-SCL-70 antibody. It was found that albumin was a protective factor for the prognosis of patients with SSC-ILD patients (p = 0.018), whereas age (p = 0.036) and IgM (p = 0.040) were risk factors. Conclusion The results of our cluster analysis indicated that based solely on histologic typing, may not be capturing the full heterogeneity of SSc-ILD patients. In order to identify homogeneous patient groups with a specific prognosis, HRCT features and antibody profiles should be taken into consideration.https://doi.org/10.1186/s12890-025-03722-wSystemic sclerosisInterstitial lung diseaseCluster analysisHRCTWarrick score
spellingShingle Yaqi Zhao
Baoting Chao
Wei Xu
Xinya Li
Jin Zhang
Ying Zhang
Zhenzhen Ma
Qingrui Yang
A noval identification of 4 systemic sclerosis - interstitial lung disease subgroups using principal component analysis-based cluster analysis
BMC Pulmonary Medicine
Systemic sclerosis
Interstitial lung disease
Cluster analysis
HRCT
Warrick score
title A noval identification of 4 systemic sclerosis - interstitial lung disease subgroups using principal component analysis-based cluster analysis
title_full A noval identification of 4 systemic sclerosis - interstitial lung disease subgroups using principal component analysis-based cluster analysis
title_fullStr A noval identification of 4 systemic sclerosis - interstitial lung disease subgroups using principal component analysis-based cluster analysis
title_full_unstemmed A noval identification of 4 systemic sclerosis - interstitial lung disease subgroups using principal component analysis-based cluster analysis
title_short A noval identification of 4 systemic sclerosis - interstitial lung disease subgroups using principal component analysis-based cluster analysis
title_sort noval identification of 4 systemic sclerosis interstitial lung disease subgroups using principal component analysis based cluster analysis
topic Systemic sclerosis
Interstitial lung disease
Cluster analysis
HRCT
Warrick score
url https://doi.org/10.1186/s12890-025-03722-w
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