Combination of imaging-immunological-clinical multimodal indicators can predict the occurrence of Sjögren's syndrome-associated interstitial lung disease
GE Wenpeng
LIANG Changhua
LI Zhenqiang
WANG Zhixia
LIANG Zhenzhen
JING Limin
Abstract：Objective To explore the predictive value of imaging features,serological immune indicators,and clinical features for interstitial lung disease in Sjögren's syndrome(SS-ILD).Methods A total of 161 patients with Sjögren's Syndrome(SS)who were treated at the First Affiliated Hospital of Henan Medical University from July 2018 to February 2025 were retrospectively enrolled;through propensity score matching(PSM),the patients were divided into the SS without interstitial lung disease(ILD)group(n=56)and the SS with ILD group(n=29).Univariate analysis was used to screen for meaningful variables,the Spearman correlation coefficient was applied to analyze the correlation between these variables and SS-ILD,binary logistic regression was performed to construct a combined prediction model,the area under the receiver operating characteristic curve(AUC)and Delong test were used to verify the predictive performance of the combined model,a calibration curve was plotted to validate the value of imaging indicators incorporated into the combined model.Results Statistically significant differences were observed between the two groups in mean spleen density,percentage of CD4⁺T cells,complement C4,Dry mouth,Dry eyes,and oral symptoms,and these variables were all negatively correlated with the occurrence of SS-ILD(all P<0.05);Logistic regression analysis revealed that the mean splenic density(AUC=0.698,sensitivity=0.759,specificity=0.607),percentage of CD4+T lymphocytes(AUC=0.677,sensitivity=0.982,specificity=0.310),and oral symptoms(AUC=0.635,sensitivity=0.339,specificity=0.931)all had independent predictive value.The three-factor combined model(AUC=0.781,sensitivity 0.862,specificity 0.554)was significantly superior to any single indicator(P<0.05).Conclusion Decreased mean splenic density,reduced percentage of CD4⁺ T lymphocytes,and absence of oral symptoms are independent predictive factors for the development of SS-ILD.The combination of these three factors can effectively improve the predictive efficacy with high sensitivity,which is helpful for the early clinical identification of high-risk patients with SS-ILD.
Keywords：Sjögren's syndrome with interstitial lung diseasemultimodal predictionmean splenic densityperipheral blood lymphocyte subsetsoral symptoms
Publication Date：2025-10-20
Online Publishing Date：2025-11-24(First online date of this platform, not the publication date of the document)
Pages：7( 1275-1281 )