Emphysema Phenotypes and Lung Cancer Risk

Overview

Journal PLoS One

Specialties General Medicine
Science

Date 2019 Jul 26

PMID 31344121

Citations 16

Authors

Jessica Gonzalez

Claudia I Henschke

David F Yankelevitz

Luis M Seijo

Anthony P Reeves

Rowena Yip

Yiting Xie

Michael Chung

Pablo Sanchez-Salcedo

Ana B Alcaide

Aranzazu Campo

Juan Berto

Maria Del Mar Ocon

Jesus Pueyo

Gorka Bastarrika

Juan P de-Torres

Javier J Zulueta

Affiliations

Soon will be listed here.

Abstract

Background: To assess the relationship between lung cancer and emphysema subtypes.

Objective: Airflow obstruction and emphysema predispose to lung cancer. Little is known, however, about the lung cancer risk associated with different emphysema phenotypes. We assessed the risk of lung cancer based on the presence, type and severity of emphysema, using visual assessment.

Methods: Seventy-two consecutive lung cancer cases were selected from a prospective cohort of 3,477 participants enrolled in the Clínica Universidad de Navarra's lung cancer screening program. Each case was matched to three control subjects using age, sex, smoking history and body mass index as key variables. Visual assessment of emphysema and spirometry were performed. Logistic regression and interaction model analysis were used in order to investigate associations between lung cancer and emphysema subtypes.

Results: Airflow obstruction and visual emphysema were significantly associated with lung cancer (OR = 2.8, 95%CI: 1.6 to 5.2; OR = 5.9, 95%CI: 2.9 to 12.2; respectively). Emphysema severity and centrilobular subtype were associated with greater risk when adjusted for confounders (OR = 12.6, 95%CI: 1.6 to 99.9; OR = 34.3, 95%CI: 25.5 to 99.3, respectively). The risk of lung cancer decreases with the added presence of paraseptal emphysema (OR = 4.0, 95%CI: 3.6 to 34.9), losing this increased risk of lung cancer when it occurs alone (OR = 0.7, 95%CI: 0.5 to 2.6).

Conclusions: Visual scoring of emphysema predicts lung cancer risk. The centrilobular phenotype is associated with the greatest risk.

Citing Articles

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