Predictive factors for postoperative acute exacerbation of interstitial pneumonia combined with lung cancer.
OBJECTIVE
Postoperative acute exacerbation (AE) of usual interstitial pneumonia (UIP) is a serious complication in the surgical treatment for primary lung cancer combined with UIP. The purpose of this study was to determine the predictors of AE of UIP after a major lung resection.


METHODS
We retrospectively collected data for 40 patients who had been operated on for lung cancer and were diagnosed as UIP based on postoperative histopathological diagnosis. We then evaluated some predictive factors related to the AE of UIP.


RESULTS
The incidence of postoperative AE of UIP was 15% (6/40 patients). No correlation between patients who developed AE of UIP and those who did not, in terms of preoperative C-reactive protein, white blood cell count, percentage lymphocytes, forced expiratory volume in 1 s, percentage total lung capacity, percentage diffusing capacity of lung for carbon monoxide, and the alveolar partial pressures of oxygen and carbon dioxide. Preoperative serum lactate dehydrogenase (LDH) and serum KL-6 were significantly higher and the percent vital capacity (%VC) was significantly lower in patients who developed AE of UIP than in those who did not. Furthermore, recursive descent partition analysis revealed that %VC (<80.6%) and LDH (>or=241 IU/l) could distinguish patients with AE from those without AE.


CONCLUSIONS
Preoperative %VC plus serum LDH values were considered the predictive factors for AE of UIP after surgery for lung cancer.
Shintani
Yasushi
Y
Department of Thoracic Surgery, Osaka Prefectural Hospital Organization, Prefectural Medical Center for Respiratory and Allergic Disease, 3-7-1 Habikino, Habikino, Osaka, 583-8588, Japan. yasushishintani@aol.com
Ohta
Mitsunori
M
Iwasaki
Teruo
T
Ikeda
Naoki
N
Tomita
Emiko
E
Kawahara
Kunimitsu
K
Ohno
Yuko
Y
D000368:Aged; D015415:Biomarkers / Q000097:blood; D016009:Chi-Square Distribution; D005260:Female; D006801:Humans; D054990:Idiopathic Pulmonary Fibrosis / Q000097:blood / Q000209:etiology* / Q000473:pathology / Q000503:physiopathology; D015994:Incidence; D007770:L-Lactate Dehydrogenase / Q000097:blood; D008175:Lung Neoplasms / Q000097:blood / Q000150:complications / Q000473:pathology / Q000503:physiopathology / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D013510:Pulmonary Surgical Procedures / Q000009:adverse effects*; D012189:Retrospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D016896:Treatment Outcome; D014797:Vital Capacity
D015415:Biomarkers; D007770:L-Lactate Dehydrogenase
Eur J Cardiothorac Surg. 2006 Oct;30(4):657-62
16893654
Ann Thorac Surg. 2006 Jul;82(1):336-8
16798250
Am J Respir Crit Care Med. 2000 Jan;161(1):5-8
10619790
J Thorac Cardiovasc Surg. 2003 Jun;125(6):1321-7
12830051
Ann Thorac Cardiovasc Surg. 2004 Dec;10(6):340-6
15658905
JAMA. 1968 Jun 24;204(13):1193-5
5694700
J Thorac Cardiovasc Surg. 1998 Jan;115(1):70-3
9451047
Surg Today. 1999;29(2):121-8
10030736
Am J Respir Crit Care Med. 1998 Nov;158(5 Pt 1):1680-4
9817725
J Surg Oncol. 2001 Jan;76(1):53-7
11223825
Thorax. 2003 Jan;58(1):52-7
12511721
J Thorac Cardiovasc Surg. 1983 Nov;86(5):654-8
6632940
N Engl J Med. 1978 Apr 13;298(15):801-9
634315
Intern Med. 2009;48(9):665-72
19420811
J Thorac Cardiovasc Surg. 1995 Feb;109(2):275-81; discussion 281-3
7853881
Clin Cancer Res. 2004 May 15;10(10):3291-300
15161682