The Incidence and Risk Analysis of Lung Cancer Development in Patients with Chronic Obstructive Pulmonary Disease: Possible Effectiveness of Annual CT-Screening.
The Incidence and Risk Analysis of Lung Cancer Development in Patients with Chronic Obstructive Pulmonary Disease: Possible Effectiveness of Annual CT-Screening.
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DOI：
10.2147/copd.s287492
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发表时间：
2021
影响因子：
2.8
通讯作者：
Watanabe M
中科院分区：
文献类型：
--
作者：
Machida H;Inoue S;Shibata Y;Kimura T;Ota T;Ishibashi Y;Murano H;Furuyama K;Yang S;Nakano H;Sato K;Sato M;Nemoto T;Nishiwaki M;Yamauchi K;Igarashi A;Watanabe M
肺癌是慢性阻塞性肺疾病（COPD）患者的严重并发症，约占COPD患者死亡人数的15%。然而，除肺气肿外，迄今为止关于COPD患者肺癌发展预测因素的报道很少。据报道，慢性阻塞性肺病患者的肺癌发病率为0.8% - 1.7%/年，但日本人群的发病率可能更高。因此，我们调查了日本COPD患者的肺癌发病率和肺癌死亡率，以及COPD患者发生肺癌的相关因素。我们随访了224例稳定期COPD患者，每年至少进行一次CT检查。记录肺癌的发病率，并将入组时的数据与未患肺癌组的数据进行比较。在中位4.58年的随访期间，有19名患者被新诊断为肺癌；该人群肺癌发病率为1.85%/年。通过CT和GOLD分类评估，肺癌患者的肺气肿更为严重，并且与未患肺癌的患者相比，吸烟者的可能性更大。两组间无其他显著差异。与未患肺癌的患者相比，患肺癌的患者死亡率显著增加。在COPD患者中，肺癌的发病率较高，肺癌的发展使预后恶化；然而，肺癌的发展是不可预测的，应引起所有患者的注意。每年的CT筛查对于早期发现肺癌很重要。
Lung cancer is a serious complication in patients with chronic obstructive pulmonary disease (COPD) and accounts for approximately 15% of deaths in patients with COPD. However, with the exception of emphysema, few reports to date have been published on the factors that predict lung cancer development in COPD patients. It has been reported that patients with COPD develop lung cancer at a rate of 0.8% - 1.7%/year, but the incidence may be higher in the Japanese population. Therefore, we investigated the incidence of lung cancer and the lung cancer mortality rate in Japanese COPD patients, as well as factors that are associated with the development of lung cancer in COPD patients. We followed up 224 patients with stable COPD and performed CT examinations at least once per year. The incidence of lung cancer was recorded and data at enrollment were compared with data of the group that did not develop lung cancer. Over a median follow-up period of 4.58 years, lung cancer was newly diagnosed in 19 patients; the incidence of lung cancer in this population was 1.85%/year. Patients who developed lung cancer had more severe emphysema assessed by CT and GOLD classification and were more likely to be current smokers than those who did not develop lung cancer. No other significant differences were observed between these two groups. Mortality was significantly increased in patients who developed lung cancer compared with those who did not. In COPD patients, the incidence of lung cancer is higher and the development of lung cancer worsens the prognosis; however, lung cancer development is unpredictable and attention should be paid to all patients. Annual CT screening is important for early detection of lung cancer.