Mucus plug and lung cancer incidence in patients with COPD

Abstract Airway mucus plugs are frequently observed on chest computed tomography (CT) scans in patients with chronic obstructive pulmonary disease (COPD). However, the association between the presence of mucus plugs and the risk of lung cancer in COPD patients has not been thoroughly investigated. T...

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Main Authors: So Jeong Kim, Heemoon Park, Hyo Jin Lee, Jung-Kyu Lee, Eun Young Heo, Kwang Nam Jin, Deog Kyeom Kim, Hyun Woo Lee
Format: Article
Language:English
Published: Nature Portfolio 2025-08-01
Series:Scientific Reports
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Online Access:https://doi.org/10.1038/s41598-025-13501-6
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author So Jeong Kim
Heemoon Park
Hyo Jin Lee
Jung-Kyu Lee
Eun Young Heo
Kwang Nam Jin
Deog Kyeom Kim
Hyun Woo Lee
author_facet So Jeong Kim
Heemoon Park
Hyo Jin Lee
Jung-Kyu Lee
Eun Young Heo
Kwang Nam Jin
Deog Kyeom Kim
Hyun Woo Lee
author_sort So Jeong Kim
collection DOAJ
description Abstract Airway mucus plugs are frequently observed on chest computed tomography (CT) scans in patients with chronic obstructive pulmonary disease (COPD). However, the association between the presence of mucus plugs and the risk of lung cancer in COPD patients has not been thoroughly investigated. This study aimed to determine whether mucus plugs are associated with an increased risk of lung cancer in COPD patients. We conducted a retrospective cohort study of COPD patients treated at a teaching hospital between 2004 and 2020. The primary outcome was the incidence of lung cancer, with secondary outcomes including lung cancer histologic subtypes. Among 616 COPD patients, 256 (41.7%) had mucus plugs, while 360 (58.4%) did not. Over a median observation period of 66 months, 56 patients developed lung cancer. Mucus plugs were significantly associated with an increased risk of lung cancer (adjusted HR = 2.281 [95% CI = 1.192–4.363], P-value = 0.013). Notably, this association was significant even in patients who did not meet conventional lung cancer screening criteria. Patients with mucus plugs also had a significantly higher incidence of squamous cell carcinoma (P-value = 0.001), but not adenocarcinoma. In COPD patients, the presence of mucus plugs is associated with a higher incidence of lung cancer, particularly squamous cell carcinoma.
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spelling doaj-art-6b67899eec144be0b90a910d554ef0b62025-08-24T11:27:21ZengNature PortfolioScientific Reports2045-23222025-08-0115111010.1038/s41598-025-13501-6Mucus plug and lung cancer incidence in patients with COPDSo Jeong Kim0Heemoon Park1Hyo Jin Lee2Jung-Kyu Lee3Eun Young Heo4Kwang Nam Jin5Deog Kyeom Kim6Hyun Woo Lee7Division of Pulmonary, Allergy and Critical Care Medicine, Department of Internal Medicine, Hallym University Dongtan Sacred Heart HospitalDivision of Respiratory and Critical Care, Department of Internal Medicine, Seoul Metropolitan Government-Seoul National University Boramae Medical Center, Seoul National University College of MedicineDivision of Respiratory and Critical Care, Department of Internal Medicine, Seoul Metropolitan Government-Seoul National University Boramae Medical Center, Seoul National University College of MedicineDivision of Respiratory and Critical Care, Department of Internal Medicine, Seoul Metropolitan Government-Seoul National University Boramae Medical Center, Seoul National University College of MedicineDivision of Respiratory and Critical Care, Department of Internal Medicine, Seoul Metropolitan Government-Seoul National University Boramae Medical Center, Seoul National University College of MedicineDepartment of Radiology, Seoul Metropolitan Government-Seoul National University Boramae Medical Center, Seoul National University College of MedicineDivision of Respiratory and Critical Care, Department of Internal Medicine, Seoul Metropolitan Government-Seoul National University Boramae Medical Center, Seoul National University College of MedicineDivision of Respiratory and Critical Care, Department of Internal Medicine, Seoul Metropolitan Government-Seoul National University Boramae Medical Center, Seoul National University College of MedicineAbstract Airway mucus plugs are frequently observed on chest computed tomography (CT) scans in patients with chronic obstructive pulmonary disease (COPD). However, the association between the presence of mucus plugs and the risk of lung cancer in COPD patients has not been thoroughly investigated. This study aimed to determine whether mucus plugs are associated with an increased risk of lung cancer in COPD patients. We conducted a retrospective cohort study of COPD patients treated at a teaching hospital between 2004 and 2020. The primary outcome was the incidence of lung cancer, with secondary outcomes including lung cancer histologic subtypes. Among 616 COPD patients, 256 (41.7%) had mucus plugs, while 360 (58.4%) did not. Over a median observation period of 66 months, 56 patients developed lung cancer. Mucus plugs were significantly associated with an increased risk of lung cancer (adjusted HR = 2.281 [95% CI = 1.192–4.363], P-value = 0.013). Notably, this association was significant even in patients who did not meet conventional lung cancer screening criteria. Patients with mucus plugs also had a significantly higher incidence of squamous cell carcinoma (P-value = 0.001), but not adenocarcinoma. In COPD patients, the presence of mucus plugs is associated with a higher incidence of lung cancer, particularly squamous cell carcinoma.https://doi.org/10.1038/s41598-025-13501-6Pulmonary diseaseChronic obstructiveMucusBronchiLung cancer
spellingShingle So Jeong Kim
Heemoon Park
Hyo Jin Lee
Jung-Kyu Lee
Eun Young Heo
Kwang Nam Jin
Deog Kyeom Kim
Hyun Woo Lee
Mucus plug and lung cancer incidence in patients with COPD
Scientific Reports
Pulmonary disease
Chronic obstructive
Mucus
Bronchi
Lung cancer
title Mucus plug and lung cancer incidence in patients with COPD
title_full Mucus plug and lung cancer incidence in patients with COPD
title_fullStr Mucus plug and lung cancer incidence in patients with COPD
title_full_unstemmed Mucus plug and lung cancer incidence in patients with COPD
title_short Mucus plug and lung cancer incidence in patients with COPD
title_sort mucus plug and lung cancer incidence in patients with copd
topic Pulmonary disease
Chronic obstructive
Mucus
Bronchi
Lung cancer
url https://doi.org/10.1038/s41598-025-13501-6
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