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

Abstract

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. 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 25ppb (N group) and above 25ppb (H group). They were evaluated by spirometry at 3 and 6months after surgery during follow-up. The relationship between postoperative lung function and preoperative FeNO was evaluated. 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 1s (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 6months in the H group were significantly increased as compared to those in the N group (p<0.001). Preoperative FeNO is a predictor of delayed lung function recovery 3months 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.