Guay Charles-Antoine, Charest Pierre-Emile, Caron Frederic-Thomas, Laflamme Louis, Perreault Laurie, Laliberté Anne-Sophie, Albert Elisabeth, Dion Genevieve, Provencher Steeve
Centre de Recherche de l'Institut universitaire de cardiologie et de pneumologie de Québec - Université Laval, Quebec City, Quebec, Canada.
Department of Medicine, Université Laval, Quebec City, Quebec, Canada.
BMJ Open Respir Res. 2025 Aug 28;12(1):e002981. doi: 10.1136/bmjresp-2024-002981.
The clinical significance of interstitial lung abnormalities in patients with lung cancer undergoing curative resection remains largely unstudied. This study aimed to evaluate the prevalence of these findings among patients with lung cancer undergoing resection and assess their impact on postoperative complications and long-term survival.
This single-centre retrospective study included patients who underwent resection from 2008 to 2020. Patients with a history of lung cancer, previous lung resection or clinically evident interstitial lung disease before cancer detection were excluded. Preoperative chest scans were reviewed for interstitial lung abnormalities according to established criteria. Associations between these abnormalities and postoperative outcomes, as well as long-term survival, were analysed using multivariate models.
Among 1802 patients with available preoperative scans, 114 (6.3%) had interstitial lung abnormalities, including 17 (0.9%) with a usual interstitial pneumonia-like pattern. Interstitial lung abnormalities were associated with older age, female sex and smoking history. Although their presence did not significantly increase the risk of postoperative complications or 30-day mortality, interstitial lung abnormalities were linked to higher long-term mortality (92 vs 61 deaths/1000 person-years, HR 1.47; 95% CI 1.05 to 2.05). The usual interstitial pneumonia-like patterns were significantly associated with increased long-term mortality (HR 2.84; 95% CI 1.36 to 5.91), whereas other patterns were not (HR 0.98; 95% CI 0.63 to 1.54).
Interstitial lung abnormalities are common in patients with lung cancer undergoing curative surgery and are linked to demographic and smoking-related factors. While they do not significantly impact short-term surgical outcomes, usual interstitial pneumonia-like pattern is associated with worse long-term survival.
接受根治性切除的肺癌患者间质性肺异常的临床意义在很大程度上仍未得到研究。本研究旨在评估这些发现在接受切除的肺癌患者中的发生率，并评估它们对术后并发症和长期生存的影响。
这项单中心回顾性研究纳入了2008年至2020年接受切除的患者。排除有肺癌病史、既往肺切除史或在癌症检测前有临床明显间质性肺疾病的患者。根据既定标准对术前胸部扫描进行间质性肺异常评估。使用多变量模型分析这些异常与术后结果以及长期生存之间的关联。
在1802例有术前扫描资料的患者中，114例（6.3%）存在间质性肺异常，其中17例（0.9%）呈普通型间质性肺炎样表现。间质性肺异常与年龄较大、女性和吸烟史有关。虽然其存在并未显著增加术后并发症或30天死亡率的风险，但间质性肺异常与较高的长期死亡率相关（每1000人年92例死亡对61例死亡，HR 1.47；95%CI 1.05至2.05）。普通型间质性肺炎样表现与长期死亡率增加显著相关（HR 2.84；95%CI 1.36至5.91），而其他表现则不然（HR 0.98；95%CI 0.63至1.54）。
间质性肺异常在接受根治性手术的肺癌患者中很常见，并且与人口统计学和吸烟相关因素有关。虽然它们对短期手术结果没有显著影响，但普通型间质性肺炎样表现与较差的长期生存相关。
