Effect of smoking cessation on quantitative computed tomography in smokers at risk in a lung cancer screening population
Effect of smoking cessation on quantitative computed tomography in smokers at risk in a lung cancer screening population
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DOI：
10.1007/s00330-017-5030-6
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发表时间：
2018-02-01
影响因子：
5.9
通讯作者：
Wielpuetz, Mark O.
中科院分区：
文献类型：
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作者：
Jobst, Bertram J.;Weinheimer, Oliver;Wielpuetz, Mark O.
纵向评估戒烟对 4 年以上重度吸烟者肺癌筛查队列中定量 CT 的影响。 4 年后，314 名长期戒烟者 (ES)、404 名持续吸烟者 (CS) 和 39 名基线 CT 后 2 年内戒烟的近期戒烟者 (RQ) 可以接受低剂量胸部 CT 检查。在基线以及 3 和 4 年后获得的 CT 数据经过良好评估的密度测定软件，计算平均肺密度 (MLD) 和肺密度直方图的第 15 个百分位数 (15TH)。在基线时，与 ES 相比（-831 +/- 31 和 -947 +/-），活跃吸烟者的 MLD 和 15TH（分别为 -822 +/- 35 和 -936 +/- 25 HU）显着更高22 HU，p < 0.01-0.001）。 3年后，CS的MLD和15TH（-801 +/- 29和-896 +/- 23 HU）再次显着高于ES（-808 +/- 27和-906 +/- 20 HU，p < 0.01-0.001），而且RQ（-813 +/- 20和-909 +/- 15 HU，p < 0.05-0.001）。 4年后定量CT参数没有显着变化。重要的是，在多变量分析中，吸烟状况独立预测基线和第 3 年的 MLD（p < 0.001）。在定量 CT 上，活跃吸烟者的肺密度高于戒烟者，并且在戒烟后持续下降，反映了吸烟引起的炎症。临床试验中定量 CT 数据的解释应考虑吸烟状况。
To longitudinally evaluate effects of smoking cessation on quantitative CT in a lung cancer screening cohort of heavy smokers over 4 years.After 4 years, low-dose chest CT was available for 314 long-term ex-smokers (ES), 404 continuous smokers (CS) and 39 recent quitters (RQ) who quitted smoking within 2 years after baseline CT. CT acquired at baseline and after 3 and 4 years was subjected to well-evaluated densitometry software, computing mean lung density (MLD) and 15th percentile of the lung density histogram (15TH).At baseline, active smokers showed significantly higher MLD and 15TH (-822 +/- 35 and -936 +/- 25 HU, respectively) compared to ES (-831 +/- 31 and -947 +/- 22 HU, p < 0.01-0.001). After 3 years, CS again had significantly higher MLD and 15TH (-801 +/- 29 and -896 +/- 23 HU) than ES (-808 +/- 27 and -906 +/- 20 HU, p < 0.01-0.001) but also RQ (-813 +/- 20 and -909 +/- 15 HU, p < 0.05-0.001). Quantitative CT parameters did not change significantly after 4 years. Importantly, smoking status independently predicted MLD at baseline and year 3 (p < 0.001) in multivariate analysis.On quantitative CT, lung density is higher in active smokers than ex-smokers, and sustainably decreases after smoking cessation, reflecting smoking-induced inflammation. Interpretations of quantitative CT data within clinical trials should consider smoking status.