Kim Taeyun, Choe Junsu, Im Yunjoo, Heo Jihye, Park Hye Yun, Kang Danbee, Shin Sun Hye
Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Kosin University Gospel Hospital, Kosin University College of Medicine, Busan, Republic of Korea.
Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea.
Sci Rep. 2025 Jul 1;15(1):20663. doi: 10.1038/s41598-025-05972-4.
Accumulating data showed that individuals with preserved ratio impaired spirometry (PRISm) have an increased risk for all-cause mortality and respiratory-related mortality compared with normal spirometry. However, the association between PRISm and lung cancer development is not known. A retrospective cohort study was conducted using the Korean National Health and Nutrition Examination Survey data between 2007 and 2017, which was linked to the Health Insurance Review and Assessment database from 2007 to 2021. Men and women aged 40 to 79 years were categorized by baseline spirometry; PRISm (FEV/FVC ≥ 0.7 and FEV < 80% pred), COPD (FEV/FVC < 0.7) and normal spirometry (FEV/FVC ≥ 0.7 and both FEV and FVC ≥ 80% pred). Incident lung cancer was defined as the presence of the International Classification of Diseases-10 C33 or C34 code. Among 26,490 individuals, 2628 (9.9%) and 3811 (14.4%) had PRISm and COPD, respectively. Compared to those with normal spirometry, those with PRISm were more likely female (72.0%) and never-smokers (70.2%). During the median follow-up of 10 years, individuals with PRISm (fully-adjusted HR = 1.83, 95% CI 1.25, 2.66) and COPD (fully-adjusted HR = 2.91, 95% CI 2.23, 3.80) had significantly higher risk of lung cancer than those with normal spirometry. The association between PRISm and lung cancer was more evident in ever smokers. This nationwide cohort study revealed that PRISm might be an independent risk factor for lung cancer development.
越来越多的数据表明，与肺功能正常的个体相比，肺功能测定比率保留受损（PRISm）的个体全因死亡率和呼吸相关死亡率风险增加。然而，PRISm与肺癌发生之间的关联尚不清楚。利用2007年至2017年韩国国家健康与营养检查调查数据进行了一项回顾性队列研究，该数据与2007年至2021年的健康保险审查与评估数据库相关联。40至79岁的男性和女性根据基线肺功能测定进行分类；PRISm（FEV/FVC≥0.7且FEV<预测值的80%）、慢性阻塞性肺疾病（COPD，FEV/FVC<0.7）和肺功能正常（FEV/FVC≥0.7且FEV和FVC均≥预测值的80%）。新发肺癌定义为存在国际疾病分类第10版C33或C34编码。在26490名个体中，分别有2628名（9.9%）和3811名（14.4%）患有PRISm和COPD。与肺功能正常的个体相比，患有PRISm的个体女性比例更高（72.0%）且从不吸烟者比例更高（70.2%）。在10年的中位随访期间，患有PRISm（完全调整后的HR=1.83，95%CI为1.25，2.66）和COPD（完全调整后的HR=2.91，95%CI为2.23，3.80）的个体患肺癌的风险显著高于肺功能正常的个体。PRISm与肺癌之间的关联在曾经吸烟者中更为明显。这项全国性队列研究表明，PRISm可能是肺癌发生的一个独立危险因素。
