In this study we have shown predictive value

Smoking is considered to affect the biological characteristics of lung cancer as a result of damage caused cytogenetic

to oxidant inhalation (BЂ "). However, smoking-related, biological damage, other than an individual develops as shown that emphysema develops

only part of smokers. This study is the first to provide clear evidence that susceptibility to

light of the devastation caused by smoking is associated with clinical aggressiveness of lung cancer in smokers. Determination of degree

emphysema by CT densitometry may be useful for accurate staging of lung cancer, as well as

to study the pathogenesis of smoking-related lung cancer. There is a wide geographical change frequency emphysema (,

). Japan has a much lower rate of emphysema than in the U.S. or the UK, probably because emphysema is almost exclusively caused by

smoking in Japan. Based on preliminary results, only 5% non-smoking lung cancer is surgery

found that emphysema by CT densitometry. Because the pathogenesis of emphysema is usually multifactorial

(

), more effort should figure out how to develop potential of emphysema affects the survival, even in

non-smoking lung cancer, especially in countries with high level of emphysema. Potential for the development of emphysema, emphysema, but he seemed to directly affect the prognostic >> << result smokers who underwent surgery for lung cancer, as well as a whole and for specific disease survival differed between Patients

and those who do not emphysema in this study. In addition, two patients without emphysema and three patients with emphysema >> << died without recurrence of cancer, and only one of these three patients died of emphysema emphysema. Major prospective studies have shown a trend increase in the incidence of lung cancer death with increasing smoking exposure (BЂ "), suggesting that the impact of smoking prevalence in proportion to lung carcinogenesis, rather than clinical aggressiveness >> << lung cancer. This is consistent with the fact that most researchers, including us, can not find a

relationship between the degree of influence of smoking and therapeutic outcome of lung cancer smoker (

). Emphysema, as well as chronic obstructive bronchitis, is a major component of chronic obstructive pulmonary disease (COPD). It is well known that people with COPD have a shorter life expectancy (

) and increased risk of lung cancer deaths (,

) than in healthy subjects. Progression of COPD is estimated clinically FEV

associated with an increased risk of death from respiratory failure (), and that of lung cancer (,

). The risk of lung cancer in patients with COPD has been attributed to disruption of mucociliary clearance (,

). During the process of cleaning, particles tend to pool in areas in violation of mucociliary clearance. This association may allow

carcinogens from the smoke in the mucous blanket to have longer exposure to these areas, leading to the development of lung cancer.

Unlike the functional assessment, previous researchers have tried to COPD class in the morphological aspect. Unfortunately, no quantitative CT emphysema nor pathological measures structural anomalies of the respiratory tract

correlates well with FEV

(). In addition, according to an agreed case-control study, quantitative computed tomography emphysema NOT >> << a risk factor for lung cancer (

). In this study we have shown predictive value of computer tomographyBЂ "diagnosed emphysema, but not FEV, in patients with surgical resection at an early stage lung cancer. These results suggest that although CT

quantitative emphysema and FEV

can be used for class COPD, these measurements may be associated differently with lung cancer. Jiang et al. estimated predictive value of surfactant proteins (SP-A) Genetic aberrations detected by fluorescence in >> << hybridization in patients with stage I nonBЂ "Small Cell Lung Cancer. They found that removing >> << SP-gene in primary bronchial epithelial cells is associated with poor prognosis (). This finding indirectly confirms our results, because, according to the literature, SP-protein is likely to be

decreases in the bronchi in patients with emphysema (

). There are several theories why the computer tomographyBЂ "diagnosed with emphysema associated with poor prognosis in patients

with lung cancer. First, patients with emphysema may have a heightened sensitivity to smoking-related, biological damage, including

DNA damage, which ultimately determines the aggressiveness of tumor cells and, secondly, increased tumor progression

in emphysema where the matrix metalloproteinazy rich (

). Ishikawa et al. reported the importance of matrix metalloproteinase in primary pulmonary parenchyma to tumor progression

(

). Thus, further research should be done to clarify the direct relationship between computer tomographyBЂ "diagnosed with emphysema and >> << various biomarkers in smokers with lung cancer. Convenient computer software to determine within a few minutes to share vokseliv damping

values ​​within, representing emphysema, without the need for extensive technical training, by creating three-dimensional

CT lung model lasix 40 mg ivp and affixing a certain threshold. Results reproducible for different audiences experience

and experience between the institutions, which allows for accurate comparison of results between different centers (

). In our study, the degree of emphysema was mildly dependent on FEV

(R = 0. 375), but does not depend on the package, the smoke (

g = 0. 091). This is consistent with what little published data on the relationship between the degree of >> << smoke exposure and the severity of emphysema (

). Thus, our patients with emphysema during the development of lung cancer, it seemed, increased susceptibility to smoking-related emphysema >>. << Our previous studies have shown that measuring the degree of emphysema is also useful for prediction of early postoperative

result with respect to risks hypoxemia, cardiovascular complications, and leakage of air into the lungs of patients undergoing cancer surgery >> << ( ,

). In addition, we found that patients with moderate to severe emphysema detected by CT is likely to hit

to reduce the effect of surgery for lung cancer (

). Thus, the procedure of emphysema using this semiautomatic diagnosis should be mandatory for patients

scheduled for surgery of lung cancer, given that it has minimal labor costs and can not be >> << invasive for the patient interventions. In conclusion, susceptibility to emphysema, along with traditional clinical variables affecting prognosis >> << result of smokers with early stage lung cancer alone. Routine use of CT densitometry in smokers

lung cancer should be mandatory. .