Autoantibody Positivity Is a Risk Factor for Chemotherapy-induced Exacerbation of Interstitial Pneumonia in Lung Cancer

Risk factors for acute exacerbation of interstitial lung disease during chemotherapy for lung cancer: a systematic review and meta-analysis

Purpose

The aim of this study was to investigate the risk factors for acute exacerbation (AE) of interstitial lung disease caused by chemotherapy for lung cancer.

Methods

We searched PubMed, Embase, and The Cochrane Library databases from the establishment of each database to April 2023. Eligible studies were included, and the data on risk factors related to AE caused by chemotherapy in interstitial lung disease were extracted.

Results

A total of 878 articles were retrieved and 21 met the inclusion criteria. The studies included 1,275 patients with lung cancer combined with interstitial lung disease. The results of the meta-analysis showed four significant risk factors for AE of interstitial lung disease, namely age < 70 years (odds ratio [OR]: 1.98, 95% confidence interval [CI]: 1.05-3.72), forced vital capacity (FVC) (MD=-9.33, 95% CI: -13.7-4.97), usually interstitial pneumonia (UIP) pattern on computed tomography (CT) (OR: 2.11, 95% CI: 1.43-3.11), and serum surfactant protein D (SP-D) (SMD: 0.35, 95% CI: 0.03-0.67).

Conclusion

When patients with lung cancer complicated with interstitial lung disease are aged < 70 years, have a UIP pattern on CT, have lower FVC values, and have higher serum levels of SP-D, chemotherapy should be carried out with care.

Detection of CEA and ProGRP Levels in BALF of Patients with Peripheral Lung Cancer and Their Relationship with CT Signs

Background

Lung cancer is a common clinical thoracic malignant tumor, which had a serious impact on the safety of patients, currently ranking first in all malignant tumors in morbidity and mortality, with generally less than 5% survival rate in 5 years.

Objective

To investigate the relationship and significance between carcinoembryonic antigen (CEA) and precursor gastrin-releasing peptide (ProGRP) changing levels in bronchoalveolar lavage fluid (BALF) and CT imaging features in patients with peripheral lung cancer.

Methods

A total of 90 patients diagnosed with peripheral lung cancer as the lung cancer group and 60 patients with benign lung diseases as the control group in our hospital from May 2019 to October 2021 were selected to compare the differences of CEA and ProGRP in BALF by the classification of CT features.

Results

The levels of CEA and ProGRP in the BALF of the lung cancer group were significantly higher than those of the control group; the proportion of patients with lobulation sign, burr sign, ground glass sign, pleural effusion, and lesion diameter ≥ 3.0 cm in the lung cancer group was higher than that in the control group; the CEA level in BALF of lung cancer patients with spicule sign, pleural effusion, and lesion diameter ≥ 3.0 cm was significantly higher than that without these symptoms, while ProGRP level in the BALF of lung cancer patients with lobulation sign, burr sign, ground glass sign, pleural effusion, and lesion diameter ≥ 3.0 cm was significantly higher than that of lung cancer patients without these symptoms.

Conclusion

The check of CEA and ProGRP in BALF in combination with CT features has a certain clinical value for the diagnosis of lung cancer. At the same time, the increased levels of CEA and ProGRP in BALF have a certain correlation with the changes of malignant signs of lung cancer in CT examination.