关键词: Acute exacerbation Cancer location Interstitial lung disease Non–small-cell lung cancer Pulmonary emphysema Video-assisted thoracic surgery

Mesh : Aged Aged, 80 and over B7-H1 Antigen / metabolism Carcinoma, Non-Small-Cell Lung / metabolism mortality pathology surgery Databases, Factual Disease Progression Female Humans Immunohistochemistry Japan Lung Diseases, Interstitial / diagnosis pathology Lung Neoplasms / metabolism mortality pathology surgery Male Middle Aged Pneumonectomy / methods mortality Postoperative Care Pulmonary Emphysema / complications Retrospective Studies Survival Analysis Thoracic Surgery, Video-Assisted Tomography, X-Ray Computed

来  源:   DOI:10.1186/s12890-020-01347-9   PDF(Sci-hub)   PDF(Pubmed)

Abstract:
BACKGROUND: Non-small-cell lung cancer (NSCLC) has been reported to develop in patients with interstitial pneumonia (IP); however, clinical, radiological, and pathological features remain to be elucidated.
METHODS: We retrieved the records of 120 consecutive NSCLC patients associated with IP who underwent surgery at Toranomon Hospital between June 2011 and May 2017. We classified the patients into three groups according to NSCLC location using high-resolution computed tomography: group A, within a fibrotic shadow and/or at the interface of a fibrotic shadow and normal lung; group B, within emphysematous tissue and/or at the interface of emphysematous tissue and normal lung; and group C, within normal lung. In 64 patients, programmed death ligand-1 (PD-L1) status was assessed with immunohistostaining.
RESULTS: Most of the patients (89; 70%) were classified as group A. This group tended to have squamous cell carcinoma with the usual interstitial pneumonia (UIP). These cancers were located mainly in the lower lobes and seven of the eight postoperative acute exacerbations (pAE) of IP developed in this group. NSCLC in the group B were mainly squamous cell carcinomas located in the upper lobes. No patient with PD-L1 negative was classified into group B. None of the patients in group C showed UIP. and most of the cancers were adenocarcinoma. The frequency of epidermal growth factor receptor mutation-positive NSCLC was the highest in this group.
CONCLUSIONS: The three groups each showed characteristic features in terms of tumor location, histopathology, PD-L1 expression, and frequency of pAEof IP.
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