title: Similar radiopathological features, but different postoperative recurrence rates, between Stage I lung cancers arising in emphysematous lungs and those arising in nonemphysematous lungs.
abstract: OBJECTIVE
  The aim of the present study was to clarify the differences between lung cancer arising in emphysematous lungs and that arising in nonemphysematous lungs with regard to radiopathological features and the postoperative recurrence rate.
  
  
  METHODS
  We retrospectively reviewed a prospective database of 212 patients who underwent major lung resection for clinically diagnosed Stage I primary lung cancer. Emphysematous lungs were identified on the basis of quantitative computed tomography (CT). The biological features of the primary tumour were diagnosed according to the presence or absence of a ground-glass component on high-resolution CT and the maximum standardized uptake value in [(18)F]-fluorodeoxyglucose positron emission tomography, in addition to conventional characteristic factors.
  
  
  RESULTS
  The risk factors for postoperative recurrence were underlying emphysema, a high maximum standardized uptake value, the absence of a ground-glass component, the pathological grade and lymph node metastasis, whereas the risk factors for lymph node metastasis were a high maximum standardized uptake value, the absence of a ground-glass component and the pathological grade. Surprisingly, these risk factors were entirely matched between patients with and without emphysematous lungs, regardless of the fact that patients with emphysematous lungs had a higher recurrence rate.
  
  
  CONCLUSIONS
  Similar clinicopathological features, but different postoperative recurrence rates, were found between Stage I lung cancers arising in emphysematous lungs and those arising in nonemphysematous lungs. It may be valuable to search for underlying molecular mechanisms that promote metastasis from primary tumours arising in emphysema, such as paracrine effects between the tumour and pulmonary emphysema.
authors.affiliation: Division of Chest Surgery, Department of Surgery and Clinical Science, Yamaguchi University Graduate School of Medicine, Ube, Yamaguchi, Japan kaueda@c-able.ne.jp.
authors.forename: Kazuhiro
authors.initials: K
authors.lastname: Ueda
authors.affiliation: Division of Chest Surgery, Department of Surgery and Clinical Science, Yamaguchi University Graduate School of Medicine, Ube, Yamaguchi, Japan.
authors.forename: Junichi
authors.initials: J
authors.lastname: Murakami
authors.affiliation: Division of Chest Surgery, Department of Surgery and Clinical Science, Yamaguchi University Graduate School of Medicine, Ube, Yamaguchi, Japan.
authors.forename: Fumiho
authors.initials: F
authors.lastname: Sano
authors.affiliation: Division of Chest Surgery, Department of Surgery and Clinical Science, Yamaguchi University Graduate School of Medicine, Ube, Yamaguchi, Japan.
authors.forename: Masataro
authors.initials: M
authors.lastname: Hayashi
authors.affiliation: Department of Radiology, St Hill Hospital, Ube, Yamaguchi, Japan.
authors.forename: Kazuyoshi
authors.initials: K
authors.lastname: Suga
authors.affiliation: Division of Chest Surgery, Department of Surgery and Clinical Science, Yamaguchi University Graduate School of Medicine, Ube, Yamaguchi, Japan.
authors.forename: Kimikazu
authors.initials: K
authors.lastname: Hamano
mesh_terms: D000368:Aged; D002289:Carcinoma, Non-Small-Cell Lung / Q000150:complications / Q000175:diagnosis / Q000601:surgery*; D005260:Female; D006801:Humans; D015994:Incidence; D007564:Japan / Q000453:epidemiology; D008175:Lung Neoplasms / Q000150:complications / Q000175:diagnosis / Q000601:surgery*; D008297:Male; D061330:Multidetector Computed Tomography / Q000379:methods*; D009364:Neoplasm Recurrence, Local / Q000000981:diagnostic imaging* / Q000453:epidemiology; D009367:Neoplasm Staging; D011013:Pneumonectomy; D049268:Positron-Emission Tomography / Q000379:methods; D011184:Postoperative Period; D011379:Prognosis; D011656:Pulmonary Emphysema / Q000000981:diagnostic imaging* / Q000209:etiology / Q000601:surgery; D012189:Retrospective Studies
keywords: Chronic obstructive pulmonary disease; Lung cancer; Maximum standardized uptake value; PET; Pulmonary emphysema