The extent of ground-glass attenuation is a risk factor of chemotherapy-related exacerbation of interstitial lung disease in patients with non-small cell lung cancer
The extent of ground-glass attenuation is a risk factor of chemotherapy-related exacerbation of interstitial lung disease in patients with non-small cell lung cancer
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DOI：
10.1007/s00280-017-3476-5
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发表时间：
2018-01-01
影响因子：
3
通讯作者：
Hattori, Noboru
中科院分区：
文献类型：
--
作者：
Masuda, Takeshi;Hirano, Chihiro;Hattori, Noboru
目的观察非小细胞肺癌（NSCLC）患者化疗相关的间质性肺疾病（ILD）急性加重（AE）。虽然AE-ILD的预后极差，但其发生尚无确定的危险因素。因此，我们回顾性研究了高分辨率计算机断层扫描（HRCT）的结果是否可以识别AE-ILD.Materials和方法的危险因素之间2005年1月和2016年12月，35例非小细胞肺癌谁接受化疗在广岛大学医院和HRCT诊断为ILD的患者入组。在双侧肺的五个水平评价磨玻璃样衰减（GGA）、网状影、蜂窝样外观和肺气肿的程度，以及微结节、牵拉性支气管扩张和实变的存在。GGA，网状，蜂窝外观，肺气肿的HRCT评分由以下公式确定：100 x总和的HRCT结果/肺area.Results的程度35例患者进行了各种第一至第五线化疗方案。9例患者（25.7%）发生AE-ILD。AE-ILD患者的GGA和网状结构的中位HRCT评分显著高于无AE-ILD患者。在单变量分析中，GGA面积评分>= 24.8，网状结构面积评分>= 19.5，KL-6水平>= 946 U/mL是显著的风险因素。多因素Logistic回归分析显示，只有GGA面积评分≥ 24.8是AE-ILD的独立危险因素。结论HRCT上GGA面积是AE-ILD的危险因素。因此，该参数可用于在化疗前预测AE-ILD的风险。
Objectives Chemotherapy-related acute exacerbation (AE) of interstitial lung disease (ILD) is observed in certain patients with non-small cell lung cancer (NSCLC) who have ILD. Although the prognosis of AE-ILD is extremely poor, there are no established risk factors for its occurrence. Therefore, we retrospectively investigated whether high-resolution computed tomography (HRCT) findings could identify risk factors for AE-ILD.Materials and methods Between January 2005 and December 2016, 35 patients with NSCLC who received chemotherapy at Hiroshima University Hospital and were diagnosed with ILD on HRCT were enrolled. The extent of ground-glass attenuation (GGA), reticulation, honeycomb appearance, and emphysema, as well as the presence of micronodules, traction bronchiectasis, and consolidation were evaluated in five levels of the lung bilaterally. The HRCT scores of GGA, reticulation, honeycomb appearance, and emphysema were determined by the following formula: 100 x sum of the extent of the HRCT findings/lung area.Results Thirty-five patients underwent various first- to fifth-line chemotherapy regimens. Nine patients (25.7%) developed AE-ILD. The median HRCT scores of GGA and reticulation were significantly higher in patients with AE-ILD than in those without. On univariate analysis, a GGA area score >= 24.8, reticulation area score >= 19.5, and KL-6 level >= 946 U/mL were significant risk factors. Multivariate logistic analysis revealed that only a GGA area score >= 24.8 was an independent risk factor of AE-ILD.Conclusions The GGA area on HRCT is a risk factor for chemotherapy-related AE-ILD. Therefore, this parameter can be used to predict the risk of AE-ILD before administering chemotherapy.