Department of Surgical Oncology, Hiroshima University, 1-2-3, Kasumi, Minami-ku, Hiroshima, 734-8551, Japan.
Department of General Thoracic Surgery, National Hospital Organization Kure Medical Center and Chugoku Cancer Center, Kure, Japan.
Gen Thorac Cardiovasc Surg. 2024 Dec;72(12):786-795. doi: 10.1007/s11748-024-02037-7. Epub 2024 May 9.
We investigated the impact of radiological interstitial lung abnormalities on the postoperative pulmonary functions of patients with non-small cell lung cancer.
A total of 1191 patients with clinical stage IA non-small cell lung cancer who underwent lung resections and pulmonary function tests ≥ 6 months postoperatively were retrospectively reviewed. Postoperative pulmonary function reduction rates were compared between patients with and without interstitial lung abnormalities and according to the radiological interstitial lung abnormality classifications. Surgical procedures were divided into wedge resection, 1-2 segment resection, and 3-5 segment resection groups.
No significant differences in postoperative pulmonary function reduction rates 6 months after wedge resection were observed between the interstitial lung abnormality [n = 202] and non-interstitial lung abnormality groups [n = 989] [vital capacity [VC]: 6.82% vs. 5.00%; forced expiratory volume in 1 s [FEV1]: 7.05% vs. 7.14%]. After anatomical resection, these values were significantly lower in the interstitial lung abnormality group than in the non-interstitial lung abnormality group [VC: 1-2 segments, 12.50% vs. 9.93%; 3-5 segments, 17.42% vs. 14.23%; FEV1: 1-2 segments: 13.36% vs. 10.27%; 3-5 segments: 17.36% vs. 14.39%]. No significant differences in postoperative pulmonary function reduction rates according to the radiological interstitial lung abnormality classifications were observed.
The presence of interstitial lung abnormalities had a minimal effect on postoperative pulmonary functions after wedge resections; however, pulmonary functions significantly worsened after segmentectomy or lobectomy, regardless of the radiological interstitial lung abnormality classification in early-stage non-small cell lung cancer.
本研究旨在探讨非小细胞肺癌患者术后肺部放射性间质异常对其肺功能的影响。
回顾性分析了 1191 例临床ⅠA 期非小细胞肺癌患者的临床资料，所有患者均接受了肺切除术，并在术后 6 个月以上进行了肺功能检查。比较了间质异常组和非间质异常组患者以及不同影像学间质异常分类患者术后肺功能下降率。手术方式分为楔形切除术、1-2 段切除术和 3-5 段切除术。
在楔形切除术后 6 个月，间质异常组（n=202）和非间质异常组（n=989）患者的术后肺功能下降率无显著差异[肺活量（VC）：6.82%比 5.00%；1 秒用力呼气容积（FEV1）：7.05%比 7.14%]。在解剖性切除术后，间质异常组患者的 VC 和 FEV1 值明显低于非间质异常组患者[1-2 段：12.50%比 9.93%；3-5 段：17.42%比 14.23%；FEV1：1-2 段：13.36%比 10.27%；3-5 段：17.36%比 14.39%]。不同影像学间质异常分类患者的术后肺功能下降率无显著差异。
在楔形切除术后，间质异常对术后肺功能的影响较小；然而，在早期非小细胞肺癌中，无论影像学间质异常分类如何，段切除术或肺叶切除术均会显著导致肺功能恶化。
