Regional emphysema score is associated with tumor location and poor prognosis in completely resected NSCLC patients

BMC Pulmonary Medicine

Hye Seon Kang¹  Sang Haak Lee²  Chang Dong Yeo²  Jung Won Heo²  Ju Sang Kim³  Seung Joon Kim⁴  Sung Kyoung Kim⁵  Jin Woo Kim⁶  Chan Kwon Park⁷ 

[1] Division of Pulmonary, Critical Care and Allergy, Department of Internal Medicine, Bucheon St. Mary’s Hospital, College of Medicine, The Catholic University of Korea;Division of Pulmonary, Critical Care and Allergy, Department of Internal Medicine, Eunpyeong St. Mary’s Hospital, College of Medicine, The Catholic University of Korea;Division of Pulmonary, Critical Care and Allergy, Department of Internal Medicine, Incheon St. Mary’s Hospital, College of Medicine, The Catholic University of Korea;Division of Pulmonary, Critical Care and Allergy, Department of Internal Medicine, Seoul St. Mary’s Hospital, College of Medicine, The Catholic University of Korea;Division of Pulmonary, Critical Care and Allergy, Department of Internal Medicine, St. Vincent’s Hospital, College of Medicine, The Catholic University of Korea;Division of Pulmonary, Critical Care and Allergy, Department of Internal Medicine, Uijeongbu St. Mary’s Hospital, College of Medicine, The Catholic University of Korea;Division of Pulmonary, Critical Care and Allergy, Department of Internal Medicine, Yeouido St. Mary’s Hospital, College of Medicine, The Catholic University of Korea;

关键词: Lung cancer;    Location;    Prognosis;    Regional emphysema;    Visual score;   

DOI  :  10.1186/s12890-020-01268-7

来源: DOAJ

【 摘 要 】

Abstract Background Lung cancer is a frequent comorbidity of chronic obstructive pulmonary disease (COPD). However, the local risk of developing lung cancer related to regional emphysema distribution and clinical outcome has not been investigated. Our aim was to evaluate the impact of regional emphysema score (RES) on tumor location and prognosis in non-small cell lung cancer (NSCLC) patients. Methods We enrolled 457 patients who underwent curative surgery for NSCLC at seven hospitals at The Catholic University of Korea from 2014 to 2018. Emphysema was visually assessed for each lobe, with the lingula as a separate lobe. Semi-quantitative emphysema scoring was classified as follows: 0 = none, 0.5 = 1 to 10%, 1 = 11 to 25%, 2 = 26 to 50%, 3 = 51 to 75%, and 4 = 76 to 100%. An RES was given to each of the six lung zone: the upper, middle, and lower lobes in the right and left lungs. Results There were 145 patients in the high RES (≥ 3) group and 312 in the low RES (< 3) group. The mean RES in each lobe with cancer was significantly higher than that in other lobes without cancer (0.51 vs. 0.37, P <  0.001). This group showed significantly shorter disease-free survival (P <  0.001), in addition, presence of COPD, low diffusing capacity of the lung for carbon monoxide (< 80), smoking status, and poor differentiation were more frequent in this group. Also, cancer in a lobe with a higher RES (odds ratio (OR) = 1.56; 95% confidence interval (CI:1.01–2.42; P = 0.04), pathologic stage ≥ III (OR = 2.23; 95% CI: 1.28–3.89; P <  0.001), and poor differentiation (OR = 1.99; 95% CI: 1.22–3.21; P <  0.001) were independent factors for tumor recurrence. Conclusions The regional severity of emphysema by visual qualification was associated with the location of lung cancer, and was an independently poor prognostic factor for tumor recurrence in completely resected NSCLC patients.

【 授权许可】

Unknown