Southampton researchers have found a new way to estimate how long someone with a progressive lung disease have left to live.
A study led by the NIHR Southampton Biomedical Research Centre has shown the size of lymph nodes in the chest can indicate how long patients with idiopathic pulmonary fibrosis (IPF) will survive.
The results, published in the European Respiratory Journal, could help identify which patients’ disease will progress fastest. They could then be given treatments to reduce the rate.
Slowing down the disease
IPF is a condition in which the lungs become scarred and breathing becomes increasingly difficult.
It's not clear what causes it, but it usually affects people who are around 70 to 75 years old, and is rare in people under 50. The average life expectancy from diagnosis is two to four years.
Several treatments can help reduce the rate at which IPF gets worse, but there's currently no treatment that can stop or reverse the scarring of the lungs.
Measuring lymph node swelling
The researchers looked at mediastinal lymphadenopathy (MLN) – the swelling of lymph nodes in the chest, in the area between the lungs that contains the heart, windpipe and food pipe (oesophagus).
They analysed data from two groups of patients with IPF – 51 patients at University Hospital Southampton between 2011 and 2016, and 92 patients at Ege Hospital Izmir in Turkey between 2008 and 2015. All patients had at least two chest CT scans.
This allowed the researchers to see if they had MLN, and if they did, to measure the size of the largest node. They measured the same node again at a later CT scan to see if it had grown.
Most of the patients had MLN at the start. Those whose lymph nodes remained the same size or reduced in size lived longer on average than those whose nodes got bigger.
The study was led by Dr Tim Wallis, BRC Respiratory Clinical Fellow, and performed in collaboration with researchers at University College London.
Dr Mark Jones, Associate Professor in Respiratory Medicine at the University of Southampton, said: “This is, to our knowledge, the first study to assess the impact of lymph node progression over time on IPF survival.
“We are now investigating the reasons why lymph nodes increase in size in patients with IPF, and hope that this could ultimately identify new treatments for patients.”
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