Some patients with antisynthetase syndrome and interstitial lung disease may still develop rapidly progressive interstitial lung disease after appropriate treatment. This study investigates the clinical features and risk factors for the development of rapidly progressive interstitial lung disease in antisynthetase syndrome with interstitial lung disease, aiming to provide a basis for early clinical identification and individualized diagnosis and treatment.

122 patients with antisynthetase syndrome with interstitial lung disease who were first diagnosed in the Department of Respiratory and Critical Care Medicine of the Affiliated Hospital of Xuzhou Medical University from August 2019 to June 2024 were collected, their clinical data were collected, and according to disease progression, they were divided into a progressive group(45 cases)and a non-progressive group(77 cases); risk factors for the occurrence of RP-ILD were analyzed using logistic regression.The predictive value of risk factors was analyzed by ROC curve.

Multifactorial logistic regression analysis showed that anti-PL-7 antibody positivity and elevated CEA were independent risk factors for the development of RP-ILD in ASS-ILD, and the high predictive value of the combination of anti-PL-7 and CEA was derived from the ROC curve(AUC=0.782), with a sensitivity and specificity of 71.1% and 80.5%, respectively. During the follow-up period, 95 of the 122 patients survived and 27 died. The observation group had 20 survivors (44.44%) and 25 deaths (55.56%), while the control group had 75 survivors (97.40%) and 2 deaths (2.60%). The observation group showed a significantly lower survival rate than the control group (P<0.05).

Patients with ASS-ILD who are positive for anti-PL-7 antibodies and have elevated CEA are at a significantly increased risk of developing RP-ILD, and such patients should be closely monitored clinically and interventions should be implemented.