Severity of pulmonary emphysema and lung cancer

Bae, Kyungsoo; Jeon, Kyung Nyeo; Lee, Seung Jun; Kim, Ho Cheol; Ha, Ji Young; Park, Sung Eun; Baek, Hye Jin; Choi, Bo Hwa; Cho, Soo Buem; Moon, Jin Il

doi:10.1097/md.0000000000005494

Cited by 25 publications

(16 citation statements)

References 24 publications

(25 reference statements)

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“…In our study, patients with LC had emphysema located predominantly in the upper lobes, obtaining results similar to those in the literature. 37 Hohberger et al 29 found that, when comparing the location of a malignant nodule with other pulmonary regions of the same patient, the probability of having a more severe emphysema in the area where LC was present was significantly higher. In our series, we did not find that the tumor was in the lobe with more emphysema within each patient.…”

Section: Discussionmentioning

confidence: 99%

Influence of the type of emphysema in the relationship between COPD and lung cancer

Mouronte-Roibás

Fernández-Villar

Ruano-Raviña

et al. 2018

COPD

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IntroductionThere are no studies analyzing the relationship between emphysema and lung cancer (LC). With this aim and in order to make some comparisons between different clinical variables, we carried out the present study.MethodsThis is a case–control study, patients with COPD and LC being the cases and subjects with stable COPD being the controls. Clinical and functional parameters, as well as the existence of radiological emphysema, were evaluated in a qualitative and quantitative way, using a radiological density of −950 Hounsfield units as a cutoff point in the images. The existence of several different types of emphysema (centrilobular, paraseptal, panacinar, or bullae) was analyzed, allowing patients to have more than one simultaneously. The extent to which lobes were involved was evaluated and the extension of emphysema was graduated for each type and location, following a quantitative scale. Differences between cases and controls were compared by using bivariate and multivariate analyzes with results expressed as OR and 95% CI.ResultsWe included 169 cases and 74 controls, 84% men with a FEV1 (%) of 61.7±18.5, with 90.1% non-exacerbators. Most of them (50%) were active smokers and 47.2% were ex-smokers. Emphysema was found in 80.2% of the subjects, the most frequent type being centrilobular (34.4%). The only significantly different factor was the presence of paraseptal emphysema (alone or combined; OR =2.2 [95% CI =1.1–4.3, P = 0.03]), with adenocarcinoma being significantly more frequent in paraseptal emphysema with respect to other types (67.2% vs 32.8%, P =0.03).ConclusionPatients with COPD and paraseptal emphysema could be a risk group for the development of LC, especially adenocarcinoma subtype.

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Section: Discussionmentioning

confidence: 99%

Influence of the type of emphysema in the relationship between COPD and lung cancer

Mouronte-Roibás

Fernández-Villar

Ruano-Raviña

et al. 2018

COPD

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“…Next, both lungs were differentiated from the surrounding chest wall and mediastinal structures. Lobe segmentation was then performed to allow automated delineation for each of the 5 pulmonary lobes using automatic lobe segmentation algorithm [ 16 ].…”

Section: Methodsmentioning

confidence: 99%

Computed tomography semi-automated lung volume quantification in SARS-CoV-2-related pneumonia

et al. 2020

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Objectives To evaluate a semi-automated segmentation and ventilated lung quantification on chest computed tomography (CT) to assess lung involvement in patients affected by SARS-CoV-2. Results were compared with clinical and functional parameters and outcomes. Methods All images underwent quantitative analyses with a dedicated workstation using a semi-automatic lung segmentation software to compute ventilated lung volume (VLV), Ground-glass opacity (GGO) volume (GGO-V), and consolidation volume (CONS-V) as absolute volume and as a percentage of total lung volume (TLV). The ratio between CONS-V, GGO-V, and VLV (CONS-V/VLV and GGO-V/VLV, respectively), TLV (CONS-V/TLV, GGO-V/TLV, and GGO-V + CONS-V/TLV respectively), and the ratio between VLV and TLV (VLV/TLV) were calculated. Results A total of 108 patients were enrolled. GGO-V/TLV significantly correlated with WBC (r = 0.369), neutrophils (r = 0.446), platelets (r = 0.182), CRP (r = 0.190), PaCO2 (r = 0.176), HCO3− (r = 0.284), and PaO2/FiO2 (P/F) values (r = − 0.344). CONS-V/TLV significantly correlated with WBC (r = 0.294), neutrophils (r = 0.300), lymphocytes (r = −0.225), CRP (r = 0.306), PaCO2 (r = 0.227), pH (r = 0.162), HCO3− (r = 0.394), and P/F (r = − 0.419) values. Statistically significant differences between CONS-V, GGO-V, GGO-V/TLV, CONS-V/TLV, GGO-V/VLV, CONS-V/VLV, GGO-V + CONS-V/TLV, VLV/TLV, CT score, and invasive ventilation by ET were found (all p < 0.05). Conclusion The use of quantitative semi-automated algorithm for lung CT elaboration effectively correlates the severity of SARS-CoV-2-related pneumonia with laboratory parameters and the need for invasive ventilation. Key Points • Pathological lung volumes, expressed both as GGO-V and as CONS-V, can be considered a useful tool in SARS-CoV-2-related pneumonia. • All lung volumes, expressed themselves and as ratio with TLV and VLV, correlate with laboratory data, in particular C-reactive protein and white blood cell count. • All lung volumes correlate with patient’s outcome, in particular concerning invasive ventilation.

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“…A few studies have shown that regional emphysema was associated with the location of lung cancer [ 9 ]. According to Bae et al [ 12 ], more severe emphysema was found in the upper lobes and a higher frequency of lung cancer was also found in the upper lobes. In the current study, the mean RES was highest at 0.55 in the upper lobe, followed by 0.35 in the lower lobe.…”

Section: Discussionmentioning

confidence: 99%

“…In contrast, panlobular emphysema produces uniform destruction of the secondary lobule, which results in homogenous low attenuation that may involve the entire lung. Recently, several studies have reported that the severity of emphysema on CT was associated with the presence of lung cancer [ 12 , 13 ]. In the degree of COPD severity, visual emphysema, as well as the airway obstruction of lung function, were independent predictors of lung cancer [ 14 ].…”

Section: Introductionmentioning

confidence: 99%

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

et al. 2020

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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.

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Severity of pulmonary emphysema and lung cancer

Cited by 25 publications

References 24 publications

Influence of the type of emphysema in the relationship between COPD and lung cancer

Influence of the type of emphysema in the relationship between COPD and lung cancer

Computed tomography semi-automated lung volume quantification in SARS-CoV-2-related pneumonia

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

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