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Airway inflammation and lung function recovery after lobectomy in patients with primary lung cancer

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Abstract

Objective

Fractional exhaled nitric oxide (FeNO), which represents airway inflammation, is an indicator of postoperative complication after lung surgery. However, its effects in the late postoperative period are unknown. The aim of this prospective study was to clarify the impact of FeNO on postoperative lung function in patients with lung cancer.

Methods

We measured preoperative FeNO using NIOX VERO® in patients with primary lung cancer. Patients were divided into two groups according to their potential airway inflammatory status: preoperative FeNO levels below 25 ppb (N group) and above 25 ppb (H group). They were evaluated by spirometry at 3 and 6 months after surgery during follow-up. The relationship between postoperative lung function and preoperative FeNO was evaluated.

Results

Between September 2017 and March 2019, 61 participants were enrolled. All of them underwent lobectomy as a curative surgery. There were no significant background variables between the two groups. Postoperative vital capacity (VC) and forced expiratory volume in 1 s (FEV1) in the H group achieved less predictive values than those in the N group, which were not significant. The postoperative VC and FEV1 from 3 to 6 months in the H group were significantly increased as compared to those in the N group (p < 0.001).

Conclusions

Preoperative FeNO is a predictor of delayed lung function recovery 3 months after lobectomy in lung cancer patients. The impact had extended to VC and FEV1. Although this impact is temporary, early postoperative intervention is expected to reduce the adverse effect.

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References

  1. Endo S, Ikeda N, Kondo T, Nakajima J, Kondo H, Yokoi K, et al. Model of lung cancer surgery risk derived from a Japanese nationwide web-based database of 78594 patients during 2014–2015. Eur J Cardiothorac Surg. 2017;52:1182–9.

    Article  Google Scholar 

  2. Okamoto K, Hayashi K, Kaku K, Kawaguchi Y, Oshio Y, Hanaoka J. Impact of fractional exhaled nitric oxide on the outcomes of lung resection surgery: a prospective study. J Thorac Dis. 2020;12:2663–711.

    Article  Google Scholar 

  3. Kearney DJ, Lee TH, Reilly JJ, DeCamp MM, Sugarbaker DJ. Assessment of operative risk in patients undergoing lung resection Importance of predicted pulmonary function. Chest. 1994;105:753–9.

    Article  CAS  Google Scholar 

  4. Sawabata N, Nagayasu T, Kadota Y, Goto T, Horio H, Mori T, et al. Risk assessment of lung resection for lung cancer according to pulmonary function: republication of systematic review and proposals by guideline committee of the Japanese association for chest surgery 2014. Gen Thorac Cardiovasc Surg. 2015;63:14–211.

    Article  Google Scholar 

  5. Korst RJ, Ginsberg RJ, Ailawadi M, Bains MS, Downey RJ Jr, Rusch VW, et al. Lobectomy improves ventilatory function in selected patients with severe COPD. Ann Thorac Surg. 1998;66:898–902.

    Article  CAS  Google Scholar 

  6. Sadeghi MH, Wright CE, Hart S, Michael C, Morice AH. Does FeNO predict clinical characteristics in chronic cough? Lung. 2018;196:59–64.

    Article  CAS  Google Scholar 

  7. Chatkin JM, Ansarin K, Silkoff PE, McClean P, Gutierrez C, Zamel N, et al. Exhaled nitric oxide as a noninvasive assessment of chronic cough. Am J Respir Crit Care Med. 1999;159:1810–3.

    Article  CAS  Google Scholar 

  8. Fujimura M, Ohkura N, Abo M, Furusho S, Waseda Y, Ichikawa Y, et al. Exhaled nitric oxide levels in patients with atopic cough and cough variant asthma. Respirology. 2008;13:359–64.

    Article  Google Scholar 

  9. American Thoracic Society; European Respiratory Society. ATS/ERS Recommendations for standardized procedures for the online and offline measurement of exhaled lower respiratory nitric oxide and nasal nitric oxide, 2005. Am J Respir Crit Care Med. 2005;171:912–30.

    Article  Google Scholar 

  10. Dweik RA, Boggs PB, Erzurum SC, Charles GL, Leigh MW, Lundberg JO, et al. An official ATS clinical practice guideline: Interpretation of exhaled nitric oxide levels (FENO) for clinical applications. Am J Respir Crit Care Med. 2011;184:602–15.

    Article  CAS  Google Scholar 

  11. O'Donnell DE, Revill SM, Webb KA. Dynamic hyperinflation and exercise intolerance in chronic obstructive pulmonary disease. Am J Respir Crit Care Med. 2001;164:770–7.

    Article  CAS  Google Scholar 

  12. Nakahara K, Monden Y, Ohno K, Miyoshi S, Maeda H, Kawashima Y. A method for predicting postoperative lung function and its relation to postoperative complications in patients with lung cancer. Ann Thorac Surg. 1985;39:260–5.

    Article  CAS  Google Scholar 

  13. Bolliger CT, Jordan P, Solèr M, Stulz P, Tamm M, Wyser C, et al. Pulmonary function and exercise capacity after lung resection. Eur Respir J. 1996;9:415–21.

    Article  CAS  Google Scholar 

  14. Iijima H, Duguet A, Eum SY, Hamid Q, Eidelman DH. Nitric oxide and protein nitration are eosinophil dependent in allergen-challenged mice. Am J Respir Crit Care Med. 2001;163:1233–40.

    Article  CAS  Google Scholar 

  15. Tajiri TA, Niimi A, Matsumoto H, Ito I, Oguma T, Otsuka K, et al. Prevalence and clinical relevance of allergic rhinitis in patients with classic asthma and cough variant asthma. Respiration. 2014;87:211–8.

    Article  CAS  Google Scholar 

  16. Asano T, Takemura M, Fukumitsu K, Takeda N, Ichikawa H, Hijikata H, et al. Diagnostic utility of fractional exhaled nitric oxide in prolonged and chronic cough according to atopic status. Allergol Int. 2017;66:344–50.

    Article  CAS  Google Scholar 

  17. Boulet LP, Chakir J, Dubé J, Laprise C, Boutet M, Laviolette M. Airway inflammation and structural changes in airway hyper-responsiveness and asthma: an overview. Can Respir J. 1998;5:16–211.

    Article  CAS  Google Scholar 

  18. Niimi A, Matsumoto H, Mishima M. Eosinophilic airway disorders associated with chronic cough. Pulm Pharmacol Ther. 2009;22:114–20.

    Article  CAS  Google Scholar 

  19. Kharitonov SA, Gonio F, Kelly C, Meah S, Barnes PJ. Reproducibility of exhaled nitric oxide measurements in healthy and asthmatic adults and children. Eur Respir J. 2003;21:433–8.

    Article  CAS  Google Scholar 

  20. Matsunaga K, Hirano T, Kawayama T, Tsuburai T, Nagase H, Aizawa H, et al. Reference ranges for exhaled nitric oxide fraction in healthy Japanese adult population. Allergol Int. 2010;59:363–7.

    Article  Google Scholar 

  21. Liu PF, Zhao DH, Qi Y, Wang JG, Zhao M, Xiao K, et al. The clinical value of exhaled nitric oxide in patients with lung cancer. Clin Respir J. 2018;12:23–30.

    Article  CAS  Google Scholar 

  22. Ichinose M, Sugiura H, Yamagata S, Koarai A, Shirato K. Increase in reactive nitrogen species production in chronic obstructive pulmonary disease airways. Am J Respir Crit Care Med. 2000;162:701–6.

    Article  CAS  Google Scholar 

  23. Saito J, Gibeon D, Macedo P, Menzies-Gow A, Bhavsar PK, Chung KF. Domiciliary diurnal variation of exhaled nitric oxide fraction for asthma control. Eur Respir J. 2014;43:474–84.

    Article  Google Scholar 

  24. Geddes D, Davies M, Koyama H, Hansell D, Pastorino U, Pepper J, et al. Effect of lung-volume-reduction surgery in patients with severe emphysema. N Engl J Med. 2000;343:239–45.

    Article  CAS  Google Scholar 

  25. Rogers ML, Henderson L, Mahajan RP, Duffy JP. Preliminary findings in the neurophysiological assessment of intercostal nerve injury during thoracotomy. Eur J Cardiothorac Surg. 2002;21:298–301.

    Article  CAS  Google Scholar 

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Acknowledgements

We would like to thank Editage (www.editage.com) for English language editing.

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Authors and Affiliations

  1. Department of Cardiothoracic Surgery, Shiga University of Medical Science, Tsukinowa-Cho Seta, Otsu, Shiga, 520-2121, Japan

    Keigo Okamoto, Kazuki Hayashi, Ryosuke Kaku, Yo Kawaguchi, Yasuhiko Oshio & Jun Hanaoka

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  1. Keigo Okamoto
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  2. Kazuki Hayashi
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  3. Ryosuke Kaku
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  4. Yo Kawaguchi
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  5. Yasuhiko Oshio
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  6. Jun Hanaoka
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Correspondence to Keigo Okamoto.

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Okamoto, K., Hayashi, K., Kaku, R. et al. Airway inflammation and lung function recovery after lobectomy in patients with primary lung cancer. Gen Thorac Cardiovasc Surg 69, 297–302 (2021). https://doi.org/10.1007/s11748-020-01464-6

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  • DOI: https://doi.org/10.1007/s11748-020-01464-6

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