Lung disease survival could be predicted from size of swollen glands

A new study from Faculty of Medicine researchers can estimate how long someone with a progressive lung disease have left to live.

The research published in the European Respiratory Journal and 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.

IPF is a condition in which the lungs become scarred and breathing becomes increasingly difficult. 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.

The study 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 results could help identify which patients’ disease will progress fastest. They could then be given treatments to reduce the rate.

The study was led by Dr Tim Wallis, BRC Respiratory Clinical Fellow and Dr Mark Jones, Associate Professor in Respiratory Medicine at the University of Southampton, in collaboration with researchers at University College London.

Dr Jones 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.”