Radiologic features of precancerous areas of the lungs in chronic obstructive pulmonary disease

Keio COPD Comorbidity Research Group, Katsuhiko Naoki

Research output: Contribution to journalArticle

2 Citations (Scopus)

Abstract

Background: Only a few studies have evaluated the radiologic features of pre-existing structural abnormalities where lung cancer may develop. This study aimed to analyze the computed tomography (CT) images of lung areas where new cancer developed in chronic obstructive pulmonary disease (COPD) patients. Patients and methods: We conducted a multicenter, longitudinal cohort study, called the Keio COPD Comorbidity Research, to assess the incidence of lung cancer. Emphysema and interstitial abnormalities were evaluated in 240 COPD patients who had baseline CT scans applicable for further digital analyses. For patients who developed lung cancer during the 3-year follow-up period, the local spherical lung density of the precancerous area was individually quantified. Results: Lung cancer was newly diagnosed in 21 participants (2.3% per year). The percentage of low attenuation area in patients who developed lung cancer was higher than that of the other patients (20.0% vs 10.4%, P=0.014). The presence of emphysema (odds ratio [OR] 4.2, 95% confidence interval [CI] 1.0–29.0, P=0.049) or interstitial lung abnormalities (OR 15.6, 95% CI 4.4–65.4, P<0.0001) independently increased the risk for lung cancer. Compared with the density of the entire lung, the local density of the precancerous area was almost the same in patients with heterogeneous emphysema, but it was higher in most patients with interstitial abnormalities. Conclusion: The presence of emphysema or interstitial abnormalities or a combination of both were independent predictors of lung cancer development in COPD patients. Furthermore, lung cancer most often developed in non-emphysematous areas or in interstitial abnormalities.

Original languageEnglish
Pages (from-to)1613-1624
Number of pages12
JournalInternational Journal of COPD
Volume12
DOIs
Publication statusPublished - 2017 May 30

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Chronic Obstructive Pulmonary Disease
Lung Neoplasms
Lung
Emphysema
Odds Ratio
Tomography
Confidence Intervals
Longitudinal Studies
Comorbidity
Cohort Studies
Incidence
Research
Neoplasms

Keywords

  • Computed tomography
  • COPD
  • Emphysema
  • Interstitial lung disease
  • Lung cancer

ASJC Scopus subject areas

  • Pulmonary and Respiratory Medicine
  • Health Policy
  • Public Health, Environmental and Occupational Health

Cite this

Radiologic features of precancerous areas of the lungs in chronic obstructive pulmonary disease. / Keio COPD Comorbidity Research Group; Naoki, Katsuhiko.

In: International Journal of COPD, Vol. 12, 30.05.2017, p. 1613-1624.

Research output: Contribution to journalArticle

Keio COPD Comorbidity Research Group ; Naoki, Katsuhiko. / Radiologic features of precancerous areas of the lungs in chronic obstructive pulmonary disease. In: International Journal of COPD. 2017 ; Vol. 12. pp. 1613-1624.
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abstract = "Background: Only a few studies have evaluated the radiologic features of pre-existing structural abnormalities where lung cancer may develop. This study aimed to analyze the computed tomography (CT) images of lung areas where new cancer developed in chronic obstructive pulmonary disease (COPD) patients. Patients and methods: We conducted a multicenter, longitudinal cohort study, called the Keio COPD Comorbidity Research, to assess the incidence of lung cancer. Emphysema and interstitial abnormalities were evaluated in 240 COPD patients who had baseline CT scans applicable for further digital analyses. For patients who developed lung cancer during the 3-year follow-up period, the local spherical lung density of the precancerous area was individually quantified. Results: Lung cancer was newly diagnosed in 21 participants (2.3{\%} per year). The percentage of low attenuation area in patients who developed lung cancer was higher than that of the other patients (20.0{\%} vs 10.4{\%}, P=0.014). The presence of emphysema (odds ratio [OR] 4.2, 95{\%} confidence interval [CI] 1.0–29.0, P=0.049) or interstitial lung abnormalities (OR 15.6, 95{\%} CI 4.4–65.4, P<0.0001) independently increased the risk for lung cancer. Compared with the density of the entire lung, the local density of the precancerous area was almost the same in patients with heterogeneous emphysema, but it was higher in most patients with interstitial abnormalities. Conclusion: The presence of emphysema or interstitial abnormalities or a combination of both were independent predictors of lung cancer development in COPD patients. Furthermore, lung cancer most often developed in non-emphysematous areas or in interstitial abnormalities.",
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author = "{Keio COPD Comorbidity Research Group} and Shotaro Chubachi and Saeko Takahashi and Akihiro Tsutsumi and Naofumi Kameyama and Katsuhiko Naoki and Katsuhiko Naoki and Kenzo Soejima and Hidetoshi Nakamura and Koichiro Asano and Tomoko Betsuyaku",
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AU - Kameyama, Naofumi

AU - Naoki, Katsuhiko

AU - Naoki, Katsuhiko

AU - Soejima, Kenzo

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AU - Asano, Koichiro

AU - Betsuyaku, Tomoko

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KW - Computed tomography

KW - COPD

KW - Emphysema

KW - Interstitial lung disease

KW - Lung cancer

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