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Schlafbezogene Atmungsstörungen, Hypoxämie und der Zusammenhang mit dem Lungenkarzinom

Sleep-disordered breathing, hypoxemia and the association with lung cancer

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Zeitschrift für Pneumologie Aims and scope

Zusammenfassung

Schlafbezogene Atmungsstörungen (SBAS) sowie chronische Lungenerkrankungen haben in der Allgemeinbevölkerung eine zunehmende und bereits hohe Prävalenz. Sowohl die SBAS als auch chronische Lungenerkrankungen verursachen hypoxämische Zustände bei den betroffenen Patienten, was zu pathophysiologischen Veränderungen führt, für die Zusammenhänge mit kardiovaskulären Erkrankungen bekannt sind. Auch für eine erhöhte Inzidenz von Malignomen per se und speziell das Lungenkarzinom sind chronische Lungenerkrankungen wie die COPD (chronisch obstruktive Lungenerkrankung), aber auch SBAS als assoziiert beschrieben. Die bisher bekannten Zusammenhänge und pathophysiologischen Mechanismen sollen in diesem Beitrag dargestellt werden. Die SBAS können sich in unterschiedlichen Formen als intermittierende und/oder chronische Hypoxämie manifestieren. Diese Hypoxämiephänotypen haben Auswirkungen auf vaskuläre Wachstumsfaktoren und auf die Tumorzellproliferation. Die Exposition humaner Lungenkarzinomzellen (menschliches Adenokarzinom Zelllinie: H1437, menschliches Plattenepithelkarzinom Zelllinie: H520) gegenüber einer Hypoxämie führt zu signifikant erhöhten Proliferationsraten mit noch unbekannten Effekten auf das Therapieansprechen und den Langzeitverlauf. Ebenso sind die klinischen Effekte von SBAS und Hypoxämiephänotypen auf den unmittelbaren postoperativen Verlauf nach anatomischen Lungenresektionen bei Lungenkarzinompatienten bislang ungeklärt.

Abstract

Sleep-disordered breathing (SDB) and chronic lung diseases have an increasing and even now high prevalence in the general population. Both SDB and chronic lung diseases cause hypoxemic states in affected patients, leading to pathophysiological changes known to be associated with cardiovascular diseases. Chronic lung diseases, such as chronic obstructive pulmonary disease (COPD) and SDB have also been described as being associated with an increased incidence of malignancies per se and especially lung cancer. This article reports on the previously known associations and pathophysiological mechanisms. The SDBs can be manifested in different forms as intermittent and/or chronic hypoxemia. These hypoxemia phenotypes affect vascular growth factors and tumor cell proliferation. Exposure of human lung carcinoma cells (human adenocarcinoma cell line H1437, human squamous cell carcinoma cell line H520) to hypoxemia leads to significantly increased proliferation rates with as yet unknown effects on the response to treatment and the long-term course. Likewise, the clinical effects of SDB and hypoxemia phenotypes on the immediate postoperative course after anatomical lung resections in lung cancer patients have not yet been clarified.

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Authors and Affiliations

  1. Klinik und Poliklinik für Innere Medizin II, Universitätsklinikum Regensburg, Regensburg, Deutschland

    C. Wiest, M. Arzt, C. Schulz, S. Stadler & M. V. Malfertheiner

  2. Klinik für Thoraxchirurgie, Universitätsklinikum Regensburg, Regensburg, Deutschland

    M. Ried

  3. Klinik für Pneumologie, Klinikum Donaustauf, Donaustauf, Deutschland

    M. V. Malfertheiner

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C. Wiest, M. Arzt, C. Schulz, S. Stadler, M. Ried und M.V. Malfertheiner geben an, dass kein Interessenkonflikt besteht.

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M. Arzt, Regensburg

C. Schöbel, Essen

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Wiest, C., Arzt, M., Schulz, C. et al. Schlafbezogene Atmungsstörungen, Hypoxämie und der Zusammenhang mit dem Lungenkarzinom. Z Pneumologie 19, 224–229 (2022). https://doi.org/10.1007/s10405-022-00449-x

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