Department of Internal Medicine, Gyeongsang National University School of Medicine and Gyeongsang National University Changwon Hospital, Changwon, Republic of Korea.
Department of Internal Medicine, Gyeongsang National University School of Medicine and Gyeongsang National University Hospital, Jinju, Republic of Korea.
Thorac Cancer. 2021 Sep;12(18):2478-2486. doi: 10.1111/1759-7714.14095. Epub 2021 Aug 1.
Preserved ratio impaired spirometry (PRISm) is a common spirometric pattern that is associated with respiratory symptoms and higher mortality rates. However, the relationship between lung cancer and PRISm remains unclear. This study investigated the clinical characteristics of lung cancer patients with PRISm and the potential role of PRISm as a prognostic factor.
We retrospectively reviewed data collected from 2014 to 2015 in the Korean Association for Lung Cancer Registry. We classified all patients into three subgroups according to lung function as follows: normal lung function; PRISm (forced expiratory volume in 1 s [FEV ] < 80% predicted and FEV /forced vital capacity [FVC] ≥ 0.7); and chronic obstructive pulmonary disease (COPD; FEV1/FVC < 0.7). In non-small cell lung cancer (NSCLC) and small cell lung cancer (SCLC), the overall survival period was compared among the three subgroups. The prognostic factors were investigated using Cox regression analysis.
Of the 3763 patients, 38.6%, 40.1%, and 21.3% had normal lung function, COPD, and PRISm, respectively. Patients with PRISm had poorer overall survival than those with COPD or normal lung function in NSCLC and SCLC (Mantel-Cox log-rank test, p < 0.05). In the risk-adjusted analysis, overall survival was independently associated with COPD (hazard ratio [HR] 1.209, p = 0.027) and PRISm (HR 1.628, p < 0.001) in NSCLC, but was only associated with PRISm (HR 1.629, p = 0.004) in SCLC.
PRISm is a significant pattern of lung function in patients with lung cancer. At the time of lung cancer diagnosis, pre-existing PRISm should be considered a predictive factor of poor prognosis.
保留比受损的肺活量测定法（PRISm）是一种常见的肺活量测定模式，与呼吸道症状和更高的死亡率有关。然而，肺癌与 PRISm 之间的关系尚不清楚。本研究调查了 PRISm 肺癌患者的临床特征，以及 PRISm 作为预后因素的潜在作用。
我们回顾性地审查了 2014 年至 2015 年韩国肺癌登记处收集的数据。我们根据肺功能将所有患者分为三组：正常肺功能；PRISm（1 秒用力呼气量[FEV]＜80%预测值且 FEV/FVC≥0.7）；和慢性阻塞性肺疾病（COPD；FEV1/FVC＜0.7）。在非小细胞肺癌（NSCLC）和小细胞肺癌（SCLC）中，比较了三组之间的总生存期。使用 Cox 回归分析探讨预后因素。
在 3763 名患者中，分别有 38.6%、40.1%和 21.3%具有正常肺功能、COPD 和 PRISm。与 COPD 或正常肺功能相比，PRISm 患者在 NSCLC 和 SCLC 中的总生存期更差（Mantel-Cox 对数秩检验，p<0.05）。在风险调整分析中，在 NSCLC 中，总生存期与 COPD（风险比[HR]1.209，p=0.027）和 PRISm（HR 1.628，p<0.001）独立相关，但仅与 SCLC 中的 PRISm（HR 1.629，p=0.004）相关。
PRISm 是肺癌患者肺功能的重要模式。在诊断肺癌时，应考虑预先存在的 PRISm 是预后不良的预测因素。
