The Impact of Different Chronic Airway Inflammatory Diseases on Pathological Types and Prognosis of Lung Cancer Patients.

Abstract

Aims/Background Chronic obstructive pulmonary disease (COPD), chronic bronchitis, and bronchial asthma are common chronic airway inflammatory diseases that have been reported to be associated with increased risk for lung cancer and impact prognosis. The purpose of this study was to investigate the impact of different chronic airway inflammatory diseases on the pathological types and prognosis of lung cancer patients. Methods A total of 200 patients with newly diagnosed lung cancer were recruited from January 2021 to January 2024. The clinical data of patients were retrospectively analyzed. According to the pathological type of lung cancer, patients were divided into small cell lung cancer (SCLC) group (n = 38) and non-small cell lung cancer (NSCLC) group (n = 162). Logistic regression was used to analyze the risk factors for SCLC. Patients were divided into airway inflammation group (n = 113) and non-airway inflammation group (n = 87) in accordance with the presence of inflammatory airway diseases. Propensity score matching (PSM) was employed to balance clinical characteristics between airway inflammation and non-airway inflammation groups, followed by Kaplan-Meier analysis to analyze the influence of airway inflammation on the overall survival of lung cancer. Cox proportional hazard model was used to analyze the influencing factors on the prognosis of lung cancer patients. Results Among all patients, 87 cases (43.5%) were lung adenocarcinoma, 65 cases (32.5%) were squamous carcinoma, 38 cases (19.0%) were SCLC, and 6 cases (3.0%) were large cell carcinoma; 72 (36.0%), 49 (24.5%) and 9 (4.5%) cases had COPD, chronic bronchitis, and bronchial asthma, respectively. Of the COPD patients, 43.1% (31/72) had squamous carcinoma, 29.2% (21/72) had SCLC, and 22.2% (16/72) was lung adenocarcinoma. In chronic bronchitis, lung adenocarcinoma has the highest proportion (27/49, 55.1%), followed by squamous carcinoma (16/49, 32.7%), and SCLC accounted for 8.2% (4/49). Logistic regression analysis showed that COPD (p = 0.012, OR [95% CI] = 2.696 [1.247-5.829]) and body mass index (BMI) (p = 0.020, OR [95% CI] = 1.132 [1.020-1.256]) were the independent influencing factors of SCLC. The Kaplan-Meier survival curves showed that the overall survival rate in the airway inflammation group was significantly worse than that in the non-airway inflammation group after PSM (p = 0.033, HR [95% CI] = 1.960 [1.039-3.697]). Cox regression analysis displayed that SCLC (p < 0.001, HR [95% CI] = 10.678 [4.416-25.822]), clinical stages (III-IV) (p = 0.003, HR [95% CI] = 3.234 [1.501-6.969]) and COPD (p = 0.014, HR [95% CI] = 1.987 [1.152-3.427]) were the risk factors affecting prognosis, while surgical treatment (p = 0.022, HR [95% CI] = 0.336 [0.132-0.854]) was a protective factor for prognosis. Conclusion COPD, chronic bronchitis and asthma differ in the distribution of different pathologic types of lung cancer. The prognosis of lung cancer patients with chronic airway inflammatory diseases was worse than that of non-chronic airway inflammatory disease. COPD was a risk factor for SCLC and an independent risk factor affecting the prognosis of lung cancer patients.