title: Correlation of regional emphysema and lung cancer: a lung tissue research consortium-based study.
abstract: BACKGROUND
  Chronic obstructive pulmonary disease and lung cancer are linked because both airflow obstruction and emphysema, on computer tomography, are independent risk factors for lung cancer. However, the local risk of malignancy relative to development of regional emphysema has not yet been defined. Specifically, it is not known if primary lung cancers are associated with regions of worse emphysema within individual patients.
  
  
  METHODS
  We performed a database analysis evaluating the association between the degree of regional emphysema as scored on computer tomography and development of primary lung cancer. We also studied the association between regional emphysema and benign lung nodules. We assembled two distinct cohorts using the National Heart, Lung, and Blood Institute's Lung Tissue Research Consortium database, hypothesizing that lung malignancy will preferentially locate in the regions of the most severe emphysema.
  
  
  RESULTS
  In the Lung Tissue Research Consortium database, 624 cases met criteria for the malignant nodule cohort and 64 were included in the benign nodule cohort. When comparing location of a malignant nodule to other lung regions within the same person, the odds of having a more severe emphysema score in the location of lung cancer was 1.342 (95% confidence interval 1.112-1.620; p = 0.0022). When comparing location of a benign nodule to other lung regions within the same person, the odds of having a more severe emphysema score in the location of the benign nodule was 1.118 (95% confidence interval 0.725-1.725; p = 0.6137).
  
  
  CONCLUSIONS
  Primary lung cancers are associated with areas of worse regional emphysema.
authors.affiliation: *Division of Pulmonary and Critical Care Medicine, Mayo Clinic, Rochester; †Department of Biostatistics and Informatics, Mayo Clinic, Rochester; ‡Department of Radiology; §Department of Epidemiology, Mayo Clinic, Rochester; ‖Division of Pulmonary and Critical Care Medicine and VAMC, University of Minnesota Medical School, Minneapolis, MN; ¶Division of Pulmonary and Critical Care Medicine, University of Minnesota Medical School, Minneapolis, MN; and #Department of Oncology-Pathology, Karolinska Institute, Stockholm, Sweden.
authors.forename: Laurie A
authors.initials: LA
authors.lastname: Hohberger
authors.forename: Darrell R
authors.initials: DR
authors.lastname: Schroeder
authors.forename: Brian J
authors.initials: BJ
authors.lastname: Bartholmai
authors.forename: Ping
authors.initials: P
authors.lastname: Yang
authors.forename: Christine H
authors.initials: CH
authors.lastname: Wendt
authors.forename: Peter B
authors.initials: PB
authors.lastname: Bitterman
authors.forename: Ola
authors.initials: O
authors.lastname: Larsson
authors.forename: Andrew H
authors.initials: AH
authors.lastname: Limper
mesh_terms: D000368:Aged; D002289:Carcinoma, Non-Small-Cell Lung / Q000453:epidemiology*; D016208:Databases, Factual; D005260:Female; D006801:Humans; D008175:Lung Neoplasms / Q000453:epidemiology*; D008297:Male; D008875:Middle Aged; D011656:Pulmonary Emphysema / Q000000981:diagnostic imaging* / Q000453:epidemiology* / Q000503:physiopathology; D012307:Risk Factors; D012720:Severity of Illness Index; D055752:Small Cell Lung Carcinoma / Q000453:epidemiology; D012907:Smoking / Q000453:epidemiology; D003074:Solitary Pulmonary Nodule / Q000453:epidemiology* / Q000473:pathology; D014057:Tomography, X-Ray Computed