Prevalence and progression of combined pulmonary fibrosis and emphysema in asymptomatic smokers: A case-control study.

Abstract:

OBJECTIVES:We aimed to estimate the prevalence of combined pulmonary fibrosis and emphysema (CPFE) and describe the follow-up CT results of CPFE in asymptomatic smokers. METHODS:This study was retrospective, and approved by an institutional review board. CT images of 2,016 current or previous male smokers who underwent low-dose chest CT at our healthcare centre were reviewed. Quantitative CT analysis was used to assess the extent of emphysema, and two radiologists visually analyzed the extent of fibrosis. Changes in fibrosis (no change, improvement, or progression) were evaluated on follow-up CT imaging (n = 42). Kaplan-Meier survival analysis, multivariate logistic regression and its ROC curve were used for survival and progression analysis. RESULTS:The prevalence of CPFE among asymptomatic male smokers was 3.1 % (63/2,016). The median follow-up period was 50.4 months, and 72.7 % (16/22) of continued smoker had progressing fibrosis on follow-up CT. CPFE progressed more rapidly in continuous smokers than in former smokers (p = 0.002). The 3.5-year follow-up period after initial CPFE diagnosis maximized the sum of sensitivity and specificity of CPFE progression prediction in continuous smokers. CONCLUSIONS:The prevalence of CPFE turned out not to be inconsiderable in asymptomatic male smokers, but serial CT follow-up would be helpful in recognizing disease progression. KEY POINTS:• The prevalence of CPFE in asymptomatic smokers is 3.1 % (63/2,016). • Progression of CPFE is associated with smoking status. • 3.5 years of follow-up period would be needed to identify CPFE progression.

journal_name

Eur Radiol

journal_title

European radiology

authors

Chae KJ,Jin GY,Han YM,Kim YS,Chon SB,Lee YS,Kwon KS,Choi HM,Lynch D

doi

10.1007/s00330-015-3617-3

subject

Has Abstract

pub_date

2015-08-01 00:00:00

pages

2326-34

issue

8

eissn

0938-7994

issn

1432-1084

journal_volume

25

pub_type

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