Kim So Jeong, Park Heemoon, Lee Hyo Jin, Lee Jung-Kyu, Heo Eun Young, Jin Kwang Nam, Kim Deog Kyeom, Lee Hyun Woo
Division of Pulmonary, Allergy and Critical Care Medicine, Department of Internal Medicine, Hallym University Dongtan Sacred Heart Hospital, Hwaseong, Republic of Korea.
Division of Respiratory and Critical Care, Department of Internal Medicine, Seoul Metropolitan Government-Seoul National University Boramae Medical Center, Seoul National University College of Medicine, Seoul, Republic of Korea.
Sci Rep. 2025 Aug 18;15(1):30193. doi: 10.1038/s41598-025-13501-6.
Airway mucus plugs are frequently observed on chest computed tomography (CT) scans in patients with chronic obstructive pulmonary disease (COPD). However, the association between the presence of mucus plugs and the risk of lung cancer in COPD patients has not been thoroughly investigated. This study aimed to determine whether mucus plugs are associated with an increased risk of lung cancer in COPD patients. We conducted a retrospective cohort study of COPD patients treated at a teaching hospital between 2004 and 2020. The primary outcome was the incidence of lung cancer, with secondary outcomes including lung cancer histologic subtypes. Among 616 COPD patients, 256 (41.7%) had mucus plugs, while 360 (58.4%) did not. Over a median observation period of 66 months, 56 patients developed lung cancer. Mucus plugs were significantly associated with an increased risk of lung cancer (adjusted HR = 2.281 [95% CI = 1.192-4.363], P-value = 0.013). Notably, this association was significant even in patients who did not meet conventional lung cancer screening criteria. Patients with mucus plugs also had a significantly higher incidence of squamous cell carcinoma (P-value = 0.001), but not adenocarcinoma. In COPD patients, the presence of mucus plugs is associated with a higher incidence of lung cancer, particularly squamous cell carcinoma.
在慢性阻塞性肺疾病（COPD）患者的胸部计算机断层扫描（CT）中经常观察到气道黏液栓。然而，COPD患者中黏液栓的存在与肺癌风险之间的关联尚未得到充分研究。本研究旨在确定黏液栓是否与COPD患者肺癌风险增加相关。我们对2004年至2020年在一家教学医院接受治疗的COPD患者进行了一项回顾性队列研究。主要结局是肺癌的发病率，次要结局包括肺癌的组织学亚型。在616例COPD患者中，256例（41.7%）有黏液栓，360例（58.4%）没有。在中位观察期66个月内，56例患者发生了肺癌。黏液栓与肺癌风险增加显著相关（校正风险比=2.281[95%置信区间=1.192 - 4.363]，P值=0.013）。值得注意的是，即使在不符合传统肺癌筛查标准的患者中，这种关联也很显著。有黏液栓的患者鳞状细胞癌的发病率也显著更高（P值=0.001），但腺癌并非如此。在COPD患者中，黏液栓的存在与肺癌，尤其是鳞状细胞癌的较高发病率相关。
