Skip to main content

Advertisement

SpringerLink
Log in

Sex-specific emphysematous changes evaluated by a three-dimensional computed tomography volumetric analysis among patients with smoking histories who underwent resection for lung cancer

  • Original Article
  • Published:
Surgery Today Aims and scope Submit manuscript

Abstract

Purpose

The present study evaluated the sex-specific susceptibility to the development of emphysema in patients with smoking histories who underwent lung cancer surgeries.

Methods

Lung cancer patients with smoking histories who underwent lung resection at the University of Tsukuba Hospital, Japan, were enrolled. Radiologic emphysematous changes were analyzed using three-dimensional computed tomography (3D-CT). The volume proportion of emphysematous lung per unit of smoking and the relationship between emphysematous change and clinicopathologic factors were evaluated.

Results

Radiologic emphysematous changes analyzed using 3D-CT per pack-year smoked, defined as the Smoking-Emphysema Index (SEI), were greater in females than males. The difference was more profound in adenocarcinoma patients than in non-adenocarcinoma patients (0.70 ± 2.30 vs. 0.21 ± 0.28, P = 0.037).

Conclusion

Female lung cancer patients are more susceptible to smoking-induced emphysema than males. The SEI may be an effective indicator for evaluating smoking-induced emphysema.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3
Fig. 4

Similar content being viewed by others

Abbreviations

3D-CT:

Three-dimensional computed tomography

COPD:

Chronic obstructive pulmonary disease

FEV1.0%:

Forced expiratory volume in 1 s

HU:

Hounsfield units

LAV%:

Low-attenuation volume percentage

SEI:

Smoking-emphysema index

Smokers:

Current and past smokers

VC%:

Vital capacity predicted

References

  1. Lee PN, Forey BA, Coombs KJ. Systematic review with meta-analysis of the epidemiological evidence in the 1900s relating smoking to lung cancer. BMC Cancer. 2012;12:385.

    Article  PubMed  PubMed Central  Google Scholar 

  2. Forey BA, Thornton AJ, Lee PN. Systematic review with meta-analysis of the epidemiological evidence relating smoking to COPD, chronic bronchitis and emphysema. BMC Pulm Med. 2011;11:36.

    Article  PubMed  PubMed Central  Google Scholar 

  3. López-Campos JL, Tan W, Soriano JB. Global burden of COPD. Respirology. 2016;21(1):14–23.

    Article  PubMed  Google Scholar 

  4. Torre LA, Siegel RL, Jemal A. Lung cancer statistics. Adv Exp Med Biol. 2016;893:1–19.

    Article  PubMed  Google Scholar 

  5. Bray F, Ferlay J, Soerjomataram I, Siegel RL, Torre LA, Jemal A. Global cancer statistics 2018: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA Cancer J Clin. 2018;68(6):394–424.

    Article  PubMed  Google Scholar 

  6. Zulueta JJ, Wisnivesky JP, Henschke CI, Yip R, Farooqi AO, McCauley DI, et al. Emphysema scores predict death from COPD and lung cancer. Chest. 2012;141(5):1216–23.

    Article  PubMed  Google Scholar 

  7. Durham AL, Adcock IM. The relationship between COPD and lung cancer. Lung Cancer. 2015;90(2):121–7.

    Article  PubMed  CAS  Google Scholar 

  8. Wang Q, Takashima S, Wang JC, Zheng LM, Sone S. Prevalence of emphysema in individuals who underwent screening CT for lung cancer in Nagano prefecture of Japan. Respiration. 2001;68(4):352–6.

    Article  PubMed  CAS  Google Scholar 

  9. Siafakas NM, Tzortzaki EG. Few smokers develop COPD. Why? Respir Med. 2002;96(8):615–24.

    Article  PubMed  CAS  Google Scholar 

  10. Pahal P, Avula A, Sharma S. Emphysema. StatPearls. Treasure Island (FL): StatPearls Publishing Copyright © 2021, StatPearls Publishing LLC.; 2021.

  11. Hersh CP, DeMeo DL, Silverman EK. National emphysema treatment trial state of the art: genetics of emphysema. Proc Am Thorac Soc. 2008;5(4):486–93.

    Article  PubMed  PubMed Central  Google Scholar 

  12. Sharafkhaneh A, Hanania NA, Kim V. Pathogenesis of emphysema: from the bench to the bedside. Proc Am Thorac Soc. 2008;5(4):475–7.

    Article  PubMed  PubMed Central  Google Scholar 

  13. Foundation for promotion of cancer research (FPCR). Cancer statistics in Japan 2018 [Internet]. Tokyo, Japan: FPCR; 2019 [cited 2019 Mar 26]. Available from: https://ganjoho.jp/en/professional/statistics/brochure/2018_en.html. Accessed 26 Mar 2019.

  14. Doll R, Gray R, Hafner B, Peto R. Mortality in relation to smoking: 22 years’ observations on female British doctors. Br Med J. 1980;280(6219):967–71.

    Article  PubMed  PubMed Central  CAS  Google Scholar 

  15. Barnes PJ. Sex differences in chronic obstructive pulmonary disease mechanisms. Am J Respir Crit Care Med. 2016;193(8):813–4.

    Article  PubMed  CAS  Google Scholar 

  16. Rojas-Martinez R, Perez-Padilla R, Olaiz-Fernandez G, Mendoza-Alvarado L, Moreno-Macias H, Fortoul T, et al. Lung function growth in children with long-term exposure to air pollutants in Mexico City. Am J Respir Crit Care Med. 2007;176(4):377–84.

    Article  PubMed  CAS  Google Scholar 

  17. Gold DR, Wang X, Wypij D, Speizer FE, Ware JH, Dockery DW. Effects of cigarette smoking on lung function in adolescent boys and girls. N Engl J Med. 1996;335(13):931–7.

    Article  PubMed  CAS  Google Scholar 

  18. Hardin M, Foreman M, Dransfield MT, Hansel N, Han MK, Cho MH, et al. Sex-specific features of emphysema among current and former smokers with COPD. Eur Respir J. 2016;47(1):104–12.

    Article  PubMed  CAS  Google Scholar 

  19. Lortet-Tieulent J, Renteria E, Sharp L, Weiderpass E, Comber H, Baas P, et al. Convergence of decreasing male and increasing female incidence rates in major tobacco-related cancers in Europe in 1988–2010. Eur J Cancer. 2015;51(9):1144–63.

    Article  PubMed  Google Scholar 

  20. Zhang Y, Ren JS, Huang HY, Shi JF, Li N, Zhang Y, et al. International trends in lung cancer incidence from 1973 to 2007. Cancer Med. 2018;7(4):1479–89.

    Article  PubMed  PubMed Central  Google Scholar 

  21. Iwano S, Kitano M, Matsuo K, Kawakami K, Koike W, Kishimoto M, et al. Pulmonary lobar volumetry using novel volumetric computer-aided diagnosis and computed tomography. Interact Cardiovasc Thorac Surg. 2013;17(1):59–65.

    Article  PubMed  PubMed Central  Google Scholar 

  22. Park HJ, Hwang JH. Quantification of emphysema with a three-dimensional chest CT scan: correlation with the visual emphysema scoring on chest CT, pulmonary function tests and dyspnea severity. J Korean Soc Radiol. 2011;65(3):247–56.

    Article  Google Scholar 

  23. Kawakami K, Iwano S, Hashimoto N, Hasegawa Y, Naganawa S. Evaluation of emphysema using three-dimensional computed tomography: association with postoperative complications in lung cancer patients. Nagoya J Med Sci. 2015;77(1–2):113–22.

    PubMed  PubMed Central  Google Scholar 

  24. Mohsen LA, Gawad EA, Ibrahiem MA. CT quantification of emphysema: is semiquantitative scoring a reliable enough method? The Egyptian. J Radiol Nucl Med. 2014;45(3):673–8.

    Google Scholar 

  25. Kim YS, Kim EY, Ahn HK, Cho EK, Jeong YM, Kim JH. Prognostic significance of CT-emphysema score in patients with advanced squamous cell lung cancer. J Thorac Dis. 2016;8(8):1966–73.

    Article  PubMed  PubMed Central  Google Scholar 

  26. Ueda K, Jinbo M, Li TS, Yagi T, Suga K, Hamano K. Computed tomography-diagnosed emphysema, not airway obstruction, is associated with the prognostic outcome of early-stage lung cancer. Clin Cancer Res. 2006;12(22):6730–6.

    Article  PubMed  Google Scholar 

  27. Dransfield MT, Washko GR, Foreman MG, Estepar RS, Reilly J, Bailey WC. Gender differences in the severity of CT emphysema in COPD. Chest. 2007;132(2):464–70.

    Article  PubMed  Google Scholar 

  28. de Torres JP, Bastarrika G, Wisnivesky JP, Alcaide AB, Campo A, Seijo LM, et al. Assessing the relationship between lung cancer risk and emphysema detected on low-dose CT of the chest. Chest. 2007;132(6):1932–8.

    Article  PubMed  Google Scholar 

  29. de Torres JP, Wilson DO, Sanchez-Salcedo P, Weissfeld JL, Berto J, Campo A, et al. Lung cancer in patients with chronic obstructive pulmonary disease. Development and validation of the COPD Lung Cancer Screening Score. Am J Respir Crit Care Med. 2015;191(3):285–91.

    Article  PubMed  Google Scholar 

  30. Domagala-Kulawik J. Effects of cigarette smoke on the lung and systemic immunity. J Physiol Pharmacol. 2008;59(Suppl 6):19–34.

    PubMed  Google Scholar 

  31. Carey MA, Card JW, Voltz JW, Germolec DR, Korach KS, Zeldin DC. The impact of sex and sex hormones on lung physiology and disease: lessons from animal studies. Am J Physiol Lung Cell Mol Physiol. 2007;293(2):L272–8.

    Article  PubMed  CAS  Google Scholar 

  32. Michnovicz JJ, Hershcopf RJ, Naganuma H, Bradlow HL, Fishman J. Increased 2-hydroxylation of estradiol as a possible mechanism for the anti-estrogenic effect of cigarette smoking. N Engl J Med. 1986;315(21):1305–9.

    Article  PubMed  CAS  Google Scholar 

  33. Tam A, Morrish D, Wadsworth S, Dorscheid D, Man SF, Sin DD. The role of female hormones on lung function in chronic lung diseases. BMC Womens Health. 2011;11:24.

    Article  PubMed  PubMed Central  Google Scholar 

  34. Hemsing N, Greaves L. Women, environments and chronic disease: shifting the gaze from individual level to structural factors. Environ Health Insights. 2009;2:127–35.

    PubMed  PubMed Central  Google Scholar 

  35. Sin DD, Cohen SB, Day A, Coxson H, Paré PD. Understanding the biological differences in susceptibility to chronic obstructive pulmonary disease between men and women. Proc Am Thorac Soc. 2007;4(8):671–4.

    Article  PubMed  CAS  Google Scholar 

  36. Smith BM, Schwartzman K, Kovacina B, Taylor J, Kasymjanova G, Brandao G, et al. Lung cancer histologies associated with emphysema on computed tomography. Lung Cancer. 2012;76(1):61–6.

    Article  PubMed  Google Scholar 

Download references

Acknowledgements

All authors have made substantial contributions. We thank all who provided substantial contributions to the concepts, design, literature research, data analysis, statistical analysis, and manuscript preparation and revision. We are grateful to F. Miyamasu, Medical English Communications Center, University of Tsukuba, for revising the language of the manuscript.

Funding

This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.

Author information

Authors and Affiliations

  1. Department of Thoracic Surgery, Faculty of Medicine, University of Tsukuba, 1-1-1 Tennodai, Tsukuba, Ibaraki, 305-8577, Japan

    Ashoka Indranatha Wijesinghe, Naohiro Kobayashi, Shinsuke Kitazawa, Naoki Maki, Takahiro Yanagihara, Yusuke Saeki, Shinji Kikuchi, Yukinobu Goto, Hideo Ichimura & Yukio Sato

Authors
  1. Ashoka Indranatha Wijesinghe
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Naohiro Kobayashi
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Shinsuke Kitazawa
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Naoki Maki
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Takahiro Yanagihara
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Yusuke Saeki
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Shinji Kikuchi
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. Yukinobu Goto
    View author publications

    You can also search for this author in PubMed Google Scholar

  9. Hideo Ichimura
    View author publications

    You can also search for this author in PubMed Google Scholar

  10. Yukio Sato
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Yukio Sato.

Ethics declarations

Conflicts of interest

All the authors certify that they have no affiliations with or involvement in any organization or entity with any financial interest or nonfinancial interest in the subject matter or materials discussed in this manuscript. The authors have no financial or proprietary interests in any material discussed in this article.

Additional information

Publisher's Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Wijesinghe, A.I., Kobayashi, N., Kitazawa, S. et al. Sex-specific emphysematous changes evaluated by a three-dimensional computed tomography volumetric analysis among patients with smoking histories who underwent resection for lung cancer. Surg Today 54, 113–121 (2024). https://doi.org/10.1007/s00595-023-02707-8

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00595-023-02707-8

Keywords

Search

Navigation