title: Predictors of long-term compensatory response of pulmonary function following major lung resection for non-small cell lung cancer.
abstract: Long-term pulmonary function which might include compensatory response (CR) significantly influences quality of life of long-term survivor after major lung resection. We investigated long-term pulmonary function after major lung resection.
  
  
  
  A total of 137 patients who had undergone lobar resection for non-small cell lung cancer (NSCLC) from May 2013 to June 2014 had spirometry at 10-14 months after surgery. Actual post-operative forced expiratory volume in 1 s (FEV1) (FEV1apo)/predicted post-operative FEV1(FEV1ppo), actual post-operative forced vital capacity (FVC) (FVCapo)/predicted post-operative FVC (FVCppo), its relationship with clinicopathological factors and immunohistochemistry for pro-surfactant protein C (pro-SPC), thyroid transcription factor-1 (TTF-1) and vascular endothelial growth factor receptor 2 (VEGFR2) were investigated.
  
  
  
  FEV1apo/FEV1pposhowed strong correlation with FVCapo/FVCppo(r = 0.628; P < 0.001). We defined greater CR as both FEV1apo/FEV1ppoand FVCapo/FVCppowere >120%. Greater CR was significantly associated with decreased smoking index (P < 0.001) and greater resected subsegments (P = 0.037). The never-smoker group revealed significantly greater CR compared with the smoker group in both FEV1apo/FEV1ppo(119.9 ± 12.5% vs 107.5 ± 14.2%; P = 0.030) and FVCapo/FVCppo(117.9 ± 9.98% vs 107.2 ± 13.1%; P = 0.046) in case-matched comparison. The expression of pro-SPC, TTF-1 and VEGFR2 in the normal lung parenchyma of greater CR group was significantly higher than those of lesser CR group (P < 0.001 for each). In addition, pro-SPC, TTF-1 and VEGFR2 expressions showed a significant correlation to the degree of CR especially in the smoker group (r = 0.631, 0.705 and 0.732, respectively; P < 0.001 for each).
  
  
  
  Our data suggest that smokers may develop lesser long-term CR after major lung resection. Decreased expression of pro-SPC, TTF-1 and VEGFR2 may indicate decreased capacity of CR, especially in patients who smoke.
authors.affiliation: Department of General Thoracic Surgery, Teikyo University School of Medicine, Tokyo, Japan.
authors.forename: Yusuke
authors.initials: Y
authors.lastname: Takahashi
authors.affiliation: Department of General Thoracic Surgery, Teikyo University School of Medicine, Tokyo, Japan.
authors.forename: Noriyuki
authors.initials: N
authors.lastname: Matsutani
authors.affiliation: Department of Pathology, Teikyo University School of Medicine, Tokyo, Japan.
authors.forename: Shigeki
authors.initials: S
authors.lastname: Morita
authors.affiliation: Department of General Thoracic Surgery, Teikyo University School of Medicine, Tokyo, Japan.
authors.forename: Hitoshi
authors.initials: H
authors.lastname: Dejima
authors.affiliation: Department of General Thoracic Surgery, Teikyo University School of Medicine, Tokyo, Japan.
authors.forename: Takashi
authors.initials: T
authors.lastname: Nakayama
authors.affiliation: Department of General Thoracic Surgery, Teikyo University School of Medicine, Tokyo, Japan.
authors.forename: Hirofumi
authors.initials: H
authors.lastname: Uehara
authors.affiliation: Department of General Thoracic Surgery, Teikyo University School of Medicine, Tokyo, Japan.
authors.forename: Masafumi
authors.initials: M
authors.lastname: Kawamura
mesh_terms: D000328:Adult; D000368:Aged; D002289:Carcinoma, Non-Small-Cell Lung / Q000473:pathology / Q000601:surgery; D005260:Female; D005541:Forced Expiratory Volume; D006801:Humans; D007564:Japan; D000069451:Long Term Adverse Effects / Q000175:diagnosis / Q000503:physiopathology; D008168:Lung / Q000473:pathology / Q000503:physiopathology; D008175:Lung Neoplasms / Q000473:pathology / Q000601:surgery; D008297:Male; D008875:Middle Aged; D011013:Pneumonectomy / Q000009:adverse effects / Q000379:methods; D011183:Postoperative Complications / Q000175:diagnosis / Q000503:physiopathology; D011184:Postoperative Period; D012307:Risk Factors; D013147:Spirometry / Q000379:methods; D042461:Vascular Endothelial Growth Factor A / Q000032:analysis
chemical_list: D042461:Vascular Endothelial Growth Factor A
keywords: airway epithelium; lung cancer; respiratory function tests; thoracic surgery