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      The regional association between bronchiectasis and lung cancer in chest CT

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          Abstract

          Background

          Limited studies have examined the association between lung cancer and bronchiectasis (BE). This study evaluated the regional association between BE and lung cancer by analyzing the lobar location of lung cancer in patients with underlying BE.

          Methods

          This clustered multi-level study enrolled patients who had underlying BE and were newly diagnosed with lung cancer between January 1, 2010 and May 30, 2013 in two referral hospitals in South Korea. By analyzing the presence of lung cancer and underlying BE as event variables at the level of lung lobes on chest computed tomography (CT), we evaluated the association of BE and lung cancer by the locations of the diseases.

          Results

          Eighty-one patients with BE and combined lung cancer were enrolled. Within 486 lung lobes of the patients, combined BE and lung cancer in the same lobe was found in 11 lobes (2.3 %). Using the general estimating equation assuming BE as a risk factor of lung cancer, the results indicated that the prevalence of lung cancer was significantly lower in the lobes with pre-existing BE (β = −1.09, p-value = 0.001).

          Conclusions

          Regionally, pre-existing BE was associated with a lower risk of the occurrence of lung cancer in the same lobe.

          Electronic supplementary material

          The online version of this article (doi:10.1186/s12890-016-0311-4) contains supplementary material, which is available to authorized users.

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          Most cited references17

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          Inflammation and necrosis promote tumour growth.

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            Bronchiectasis.

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              Assessing the relationship between lung cancer risk and emphysema detected on low-dose CT of the chest.

              Identification of risk factors for lung cancer can help in selecting patients who may benefit the most from smoking cessation interventions, early detection, or chemoprevention. To evaluate whether the presence of emphysema on low-radiation-dose CT (LDCT) of the chest is an independent risk factor for lung cancer. The study used data from a prospective cohort of 1,166 former and current smokers participating in a lung cancer screening study. All individuals underwent a baseline LDCT and spirometry followed by yearly repeat LDCT studies. The incidence density of lung cancer among patients with and without emphysema on LDCT was estimated. Stratified and multiple regression analyses were used to assess whether emphysema is an independent risk factor for lung cancer after adjusting for age, gender, smoking history, and the presence of airway obstruction on spirometry. On univariate analysis, the incidence density of lung cancer among individuals with and without emphysema on LDCT was 25.0 per 1,000 person-years and 7.5 per 1,000 person-years, respectively (risk ratio [RR], 3.33; 95% confidence interval [CI], 1.41 to 7.85). Emphysema was also associated with increased risk of lung cancer when the analysis was limited to individuals without airway obstruction on spirometry (RR, 4.33; 95% CI, 1.04 to 18.16). Multivariate analysis showed that the presence of emphysema (RR, 2.51; 95% CI, 1.01 to 6.23) on LDCT but not airway obstruction (RR, 2.10; 95% CI, 0.79 to 5.58) was associated with increased risk of lung cancer after adjusting for potential cofounders. Results suggest that the presence of emphysema on LDCT is an independent risk factor for lung cancer.
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                Author and article information

                Contributors
                endiar@naver.com
                kauri670@empal.com
                wlsrhkdska@gmail.com
                jk1909@empas.com
                eunyoungheo@gmail.com
                mocabery@hanmail.net
                heechung@snu.ac.kr
                +82-2-870-2228 , kimdkmd@snu.ac.kr
                Journal
                BMC Pulm Med
                BMC Pulm Med
                BMC Pulmonary Medicine
                BioMed Central (London )
                1471-2466
                15 November 2016
                15 November 2016
                2016
                : 16
                : 151
                Affiliations
                [1 ]Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Republic of Korea
                [2 ]Department of Radiology, Seoul National University College of Medicine, Seoul Metropolitan Government-Seoul National University Boramae Medical Center, Seoul, Republic of Korea
                [3 ]Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Seoul National University College of Medicine, Seoul Metropolitan Government-Seoul National University Boramae Medical Center, 20 Boramaero-5-Gil, Dongjak-Gu, Seoul 156-707 Republic of Korea
                Article
                311
                10.1186/s12890-016-0311-4
                5111282
                27846869
                f3b0d6ea-3a3f-4b02-b38f-7ded6a303fe6
                © The Author(s). 2016

                Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License ( http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver ( http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.

                History
                : 4 July 2016
                : 7 November 2016
                Categories
                Research Article
                Custom metadata
                © The Author(s) 2016

                Respiratory medicine
                bronchiectasis,lung cancer,regional association,lung lobes,chest ct
                Respiratory medicine
                bronchiectasis, lung cancer, regional association, lung lobes, chest ct

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