جهت دسترسی به کاربرگه ی زیر، از این لینک استفاده کنید. http://dl.kums.ac.ir/handle/Hannan/115948
Title: Relationship Between Emphysema Severity and the Location of Lung Cancer in Patients With Chronic Obstructive Lung Disease
Authors: Lim, J;Shin, K M;Lee, K;Lim, J K;Kim, H J;Cho, S H;Cha, S I
Keywords: Adult;Aged;Aged, 80 and over;Bronchoscopy;Female;Human;Lung Neoplasms/complications/*physiopathology/*rad;Male;Middle Aged;Obstructive/complications/*physiopathology/*radiog;Phenotype;Pulmonary Disease, Chronic;Pulmonary Emphysema/complications/*physiopathology;Radiographic Image Interpretation, Computer-Assist;Respiratory Function Tests;Retrospective Studies;Risk Factors;Severity of Illness Index;Tomography, X-Ray Computed
Year: 2015
Abstract: OBJECTIVE: New phenotypes of chronic obstructive pulmonary disease (COPD) based on emphysema severity have been recognized recently. The purpose of this study was to determine the relationship between emphysema severity (phenotype) and lung cancer location in patients with COPD. MATERIALS AND METHODS: Four hundred patients with 405 primary lung cancers confirmed pathologically between January 2010 and March 2014 were included in the study. Of these, 193 patients received a diagnosis of COPD according to the Global Initiative for Chronic Obstructive Lung Disease guidelines. We scored emphysema severity (0-4) on thin-section CT and assigned the anatomic tumor location of lung cancer as peripheral or central. RESULTS: Patients with COPD had a higher proportion of centrally located lung cancer compared with those without COPD (36.4% vs 17.4%; p < 0.001). In patients with COPD, lower emphysema grades (odds ratio [OR], 0.69; 95% CI, 0.51-0.93; p = 0.016) and reduced ratio of forced expiratory volume in 1 second (FEV1) to forced vital capacity (FVC) (OR, 0.94; 95% CI, 0.89-0.99; p = 0.024) were associated with central location. After adjusting for age, smoking, and spirometry results, the proportion of central location was approximately four times higher in patients with lower emphysema grades (0-2, < 25%) than in those with severe grades (grade 4, > 51%). CONCLUSION: Lower emphysema grades and reduced FEV1/FVC seemed to be independent predictors of central location of lung cancer in COPD. Therefore, in patients with COPD with lower grade emphysema and airway-predominant disease, additional screening tools may have to be considered for central lung cancer detection along with thin-section CT.
URI: http://dl.kums.ac.ir/handle/Hannan/115948
ISSN: 0361-803x
volume: Volume 205
Issue: Issue 3
month: September
More Information: Volume : 205Issue : 3Start page : 540
END PAGES : 545
Appears in Collections:American Journal of Roentgenology

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