論文No2441
High prevalence of airway obstruction and pulmonary emphysema in urothelial (renal pelvis, ureter, and bladder) cancer patients
Megumi Naka, Saki Shuto, Chisato Konishi, Koichi Maekawa
Respiratory Investigation, Volume 58, Issue 4, July 2020, Pages 239-245
＜背景＞
タバコ煙はCOPDの主な原因であり、これらの患者は尿路系がんを含む他の喫煙関連疾患の合併症を呈する。
しかし、尿路系がん患者におけるCOPDあるいは気流閉塞の頻度は報告されていない。
＜方法＞
新規診断された尿路系がんにおいて気流閉塞(FEV1/FVC <70%) の頻度を調べ、
尿路系がん患者における気流閉塞のリスク因子を同定した。
さらに、我々は気流閉塞と尿路系がんの両方をもつ患者と気流閉塞が健康診断時に発見された患者の特徴を比較した。
＜結果＞
我々の施設で研究期間中に新規に診断された尿路系がんは217名であった。
このうち、210名(96.8%)で肺機能評価が可能であり、38.6%(81名)に気流閉塞が存在した。
尿路系がん患者において、年齢、喫煙指数(pack-years)、BMIは多変量解析で気流閉塞の有意なリスク因子であった
(p = 0.007, p < 0.0001, and p = 0.035, respectively)。
性別、がんのステージ、がんの部位は有意なリスク因子ではなかった。
気流閉塞と尿路系がんの両方をもつ患者は気流閉塞のみの群と比較してより肺気腫の程度がひどかった
(unpaired t-test, p = 0.0003)。
＜感想＞
尿路系がん患者において38.6%に気流閉塞が存在していたようです。
年齢、喫煙状態、BMIは有意な気流閉塞のリスク因子だったようです。
Background
Cigarette smoking is a major cause of COPD, with patients also presenting complications that stem from other smoking-related diseases, including urothelial cancer. However, the prevalence of COPD or airflow obstruction in urothelial cancer patients has not been well studied.
Methods
We investigated the prevalence of airflow obstruction (FEV1/FVC < 70%) in newly diagnosed urothelial cancer patients and identified the risk factors for airflow obstruction in existing urothelial cancer patients. Additionally, we compared the characteristics of subjects who had been diagnosed with both airflow obstruction and urothelial cancer, and subjects whose airflow obstruction was discovered during health screenings.
Results
A total of 217 patients were newly diagnosed with urothelial cancer during the study period at our institution. Among all patients, 210 (96.8%) underwent an evaluable lung function test, in which 38.6% (81 patients) displayed airflow obstruction defined as FEV1/FVC < 70%. In urothelial cancer patients, age, smoking index (pack-years), and BMI proved to be significant risk factors for airflow obstruction in multivariate logistic regression (p = 0.007, p < 0.0001, and p = 0.035, respectively). Gender, cancer stage, and cancer location were not significant risk factors. Patients with both airflow obstruction and urothelial cancer showed a more advanced emphysematous change than subjects presenting with airflow obstruction alone (unpaired t-test, p = 0.0003).
Conclusions
Airflow obstruction was identified in 38.6% of urothelial cancer patients. Age, smoking index (pack-years), and BMI were significant risk factors. A significantly higher emphysematous score was observed in subjects with urothelial cancer than in subjects with airway obstruction alone.