The predictive association between radiological findings and lung cancer development in patients exposed to sulfur mustard gas: 4 decades follow up of 719 victims

BMC Pulmonary Medicine

Research

Ali Shirkhoda¹  Alireza Mohamadian²  Reza Jalli³  Aria Ghahramani⁴  Davood Mehrabani⁵  Shahin Kavousi⁶  Hossein Akbarialiabad⁶ 

[1] Department of Radiology and Diagnostic Imaging, University of California, 92697, Irvine, CA, USA;Department of Radiology, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran;Students’ Scientific Research Center (SSRC), Tehran University of Medical Sciences, Tehran, Iran;Medical Imaging Research Center, Department of Radiology, Shiraz University of Medical Sciences, Shiraz, Iran;Pennsylvania State University College of Medicine, 500 University Drive, 17033, Hershey, PA, USA;Stem Cell Technology Research Center, Associate Professor of Pathology, Shiraz University of Medical Sciences, Shiraz, Iran;Student Research Committee, School of Medicine, Shiraz University of Medical Sciences and Health Services, Shiraz, Iran;

关键词: Mustard gas;    Lung neoplasms;    Bronchiolitis obliterans;    Pulmonary fibrosis;    Bronchiectasis;   

DOI  :  10.1186/s12890-022-02282-7

 received in 2022-02-13, accepted in 2022-12-12,  发布年份 2022

来源: Springer

【 摘 要 】

BackgroundRespiratory diseases are the leading cause of morbidity and mortality in the survivors exposed to Sulfur Mustard (SM). The late abnormalities can be present as chronic bronchitis, tracheobronchial stenosis, asthma, bronchiectasis, airway narrowing, lung fibrosis, and lung cancers. This study aims to investigate the association between radiological findings and lung cancer development in patients exposed to sulfur mustard gas.MethodsWe entered 719 victims exposed to SM during the Iran–Iraq war into our follow-up study in a consensus manner. They were periodically followed with Chest HRCT scans from 2001 to an interval of 2014–2019. The mean year interval between exposure and the last follow-up was 38 years. For confirming the lung cancer in those with evidence of malignancy in their imaging, fine needle aspiration/biopsy and/or surgical intervention were done.ResultsAmong 719 patients, 57% were free from any pathologic findings in their HRCT scan. Among the subjects who had the abnormal radiologic findings, Air Trapping (AT), Lung Fibrosis (LF), Bronchiectasis (B), and the evidence of lung cancer were found in 265 (36.9%), 207 (28.8%), 151 (21.0%), and 42 (5.8%), respectively. Adenocarcinoma (38.1%) was the most common type of cancer. The right lung was involved more than the left one regarding LF, B, and cancer (p value < 0.05). Considering the laterality, a significant correlation was found between the side of LF and B and the tumor side. Furthermore, it was shown that the lung lobes with LF were statistically correlated to tumor-involved lobes. The relative risk of AT and B existence for tumor development was 11.73 [4.87–28.26] and 10.14 [5.12–20.090], respectively. The most predictive finding was LF which caused the risk of developing tumor 17.75 [7.35–42.86] times higher in the patient with this pathology. By each increment of the number of LF and B, the risk of developing tumors increased by 51% and 76%, respectively.ConclusionIn survivors exposed to Sulfur Mustard, those with bronchiectasis and lung fibrosis have a significantly higher risk of developing lung cancers, so a close follow-up of these victims is recommended.Trial registration This study was confirmed by the institutional review board and ethics committee at Shiraz University of Medical Sciences (SUMS) with the ethical code IR.SUMS.MED.REC.1399.637.

【 授权许可】

CC BY   
© The Author(s) 2022

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