Abstract

BackgroundEmphysema in asymptomatic heavy smokers can be detected during CT-scan screening for lung cancer. Metalloproteinases (MMPs) have been found to play a role in the pathogenesis of chronic obstructive pulmonary disease and to possibly serve as biomarkers for emphysema.MethodsThe NYU Lung Cancer Biomarker Center enrolled study subjects over 50 years of age with lung cancer risk factors from January 1, 2010, to December 31, 2015. These subjects received chest multi-detector computed tomography, spirometry, and provided serum for immunoassays for metalloproteinases (MMP) -1, -2, -7, -9, -10 and tissue inhibitor of metalloproteinases (TIMP) -1 and -2.ResultsThree hundred sixteen study subjects were enrolled. Of the 222 patients who met the inclusion criteria, 46% had emphysema. Smokers with emphysema had increased pack-years of smoking compared to smokers without emphysema (51 ± 24 pack-years (mean ± sd) versus 37 ± 20; p < 0.0001). Smokers with emphysema also had lower FEV1/FVC percent compared to smokers without emphysema (68 ± 11 (mean ± sd) versus 75 ± 8; p < 0.0001). Increased age and pack-years of smoking were associated with increased odds of emphysema. None of the metalloproteinases or tissue inhibitors of metalloproteinases were useful to predict the presence of emphysema in smokers.ConclusionEmphysema was detected by CT in almost half of heavy urban smokers. Serum MMP levels provided minimal additional information to improve the detection of mild emphysema among smokers given their clinical characteristics (age, pack-years, and FEV1/FVC ratio).

Highlights

  • In the United States, the prevalence of chronic obstructive pulmonary disease (COPD) is estimated to be 24 million individuals, of which half remains undiagnosed, and it is the third leading cause of death worldwide [1]

  • The aim of this study is to evaluate the utility of serum matrix metalloproteinases (MMPs) levels in the identification of patients with asymptomatic emphysema

  • The results indicated that all biomarkers had significantly different distributions by batch with the exception of MMP-1 (Supplement Table 2)

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Summary

Introduction

In the United States, the prevalence of chronic obstructive pulmonary disease (COPD) is estimated to be 24 million individuals, of which half remains undiagnosed, and it is the third leading cause of death worldwide [1]. Detection of emphysema may act as a catalyst for patients to quit smoking and subsequently prevent worsening lung function. Lung cancer screening can be useful to detect emphysema in asymptomatic heavy smokers, [73% sensitivity and 88% specificity based on the NELSON Trials [6]]. There will still be a cohort of asymptomatic smokers who will remain undiagnosed. Emphysema in asymptomatic heavy smokers can be detected during CT-scan screening for lung cancer. Metalloproteinases (MMPs) have been found to play a role in the pathogenesis of chronic obstructive pulmonary disease and to possibly serve as biomarkers for emphysema

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