Respiratory symptoms associated with a new lobe-based bronchial scoring system in an urban Chinese low-dose CT screening population.

OBJECTIVE

To develop a lobe-based bronchial scoring system in a general Chinese urban population undergoing low-dose CT (LDCT) screening and examining the association between the scores and the presence and absence of respiratory symptoms.

MATERIALS AND METHODS

A total of 989 Chinese participants aged 40-74 from the NELCIN-B3 study underwent LDCT screening. The scoring system assessed bronchiectasis by summing up CT findings in each of the five lung lobes, including severity and extent of bronchial dilatation and airway wall thickness, as well as the presence of mucoid impaction. The modified Reiff score was used as comparison. Multivariable logistic regression analyses were performed to examine the relationship between bronchial scores and respiratory symptoms.

RESULTS

The study included 44.8% men with a median age of 62 years. Among 416 participants with bronchiectasis, mild bronchial dilatation and airway wall thickening of one generation were most common in the right lower lobe (20.7% and 15.2%, respectively). The percentage of lung lobes with bronchiectasis aligned with the modified Reiff score, showing high percentages in the right lower lobe of moderate score and of high score (92% and 90%, respectively). Multivariable analysis showed that high score was associated with wheeze (OR: 2.35; 95% CI: 1.16-4.75), especially in the upper lung region (OR: 2.25; 95% CI: 1.04-4.88), and with a lower likelihood of chest pain (OR: 0.49; 95% CI: 0.28-0.88).

CONCLUSION

In a general Chinese urban population, over 40% of participants had bronchiectasis, mostly in the lower lung regions. Higher bronchial scores were positively associated with wheeze and negatively associated with chest pain.

KEY POINTS

Question Bronchiectasis is frequently detected on low-dose CT lung cancer screening. However, a lob-based bronchial scoring, its clinical relevance and association with respiratory symptoms are lacking. Findings Over 40% of participants had bronchiectasis, mostly in the lower lobes. Higher bronchial scores were associated with increased wheeze risk and reduced chest pain. Clinical relevance Early detection of bronchiectasis through CT-based scoring in lung cancer screening can improve assessment of respiratory health, enabling timely interventions and potentially reducing disease progression. Future research should explore the clinical implications of our new bronchial scoring system.