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Risk of Lung Cancer Associated with COPD Phenotype Based on Quantitative Image Analysis.


ABSTRACT: Chronic obstructive pulmonary disease (COPD) is a risk factor for lung cancer. This study evaluates alternative measures of COPD based on spirometry and quantitative image analysis to better define a phenotype that predicts lung cancer risk.A total of 341 lung cancer cases and 752 volunteer controls, ages 21 to 89 years, participated in a structured interview, standardized CT scan, and spirometry. Logistic regression, adjusted for age, race, gender, pack-years, and inspiratory and expiratory total lung volume, was used to estimate the odds of lung cancer associated with FEV1/FVC, percent voxels less than -950 Hounsfield units on the inspiratory scan (HUI) and percent voxels less than -856 HU on expiratory scan (HUE).The odds of lung cancer were increased 1.4- to 3.1-fold among those with COPD compared with those without, regardless of assessment method; however, in multivariable modeling, only percent voxels <-856 HUE as a continuous measure of air trapping [OR = 1.04; 95% confidence interval (CI), 1.03-1.06] and FEV1/FVC < 0.70 (OR = 1.71; 95% CI, 1.21-2.41) were independent predictors of lung cancer risk. Nearly 10% of lung cancer cases were negative on all objective measures of COPD.Measures of air trapping using quantitative imaging, in addition to FEV1/FVC, can identify individuals at high risk of lung cancer and should be considered as supplementary measures at the time of screening for lung cancer.Quantitative measures of air trapping based on imaging provide additional information for the identification of high-risk groups who might benefit the most from lung cancer screening. Cancer Epidemiol Biomarkers Prev; 25(9); 1341-7. ©2016 AACR.

SUBMITTER: Schwartz AG 

PROVIDER: S-EPMC5010488 | biostudies-literature | 2016 Sep

REPOSITORIES: biostudies-literature

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Risk of Lung Cancer Associated with COPD Phenotype Based on Quantitative Image Analysis.

Schwartz Ann G AG   Lusk Christine M CM   Wenzlaff Angela S AS   Watza Donovan D   Pandolfi Stephanie S   Mantha Laura L   Cote Michele L ML   Soubani Ayman O AO   Walworth Garrett G   Wozniak Antoinette A   Neslund-Dudas Christine C   Ardisana Amy A AA   Flynn Michael J MJ   Song Thomas T   Spizarny David L DL   Kvale Paul A PA   Chapman Robert A RA   Gadgeel Shirish M SM  

Cancer epidemiology, biomarkers & prevention : a publication of the American Association for Cancer Research, cosponsored by the American Society of Preventive Oncology 20160706 9


<h4>Background</h4>Chronic obstructive pulmonary disease (COPD) is a risk factor for lung cancer. This study evaluates alternative measures of COPD based on spirometry and quantitative image analysis to better define a phenotype that predicts lung cancer risk.<h4>Methods</h4>A total of 341 lung cancer cases and 752 volunteer controls, ages 21 to 89 years, participated in a structured interview, standardized CT scan, and spirometry. Logistic regression, adjusted for age, race, gender, pack-years,  ...[more]

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