这项研究旨在评估肺一氧化碳弥散能力（DLCO）与肺腺癌（ADC）侵袭性之间的潜在关系。研究回顾性审查了2001年至2018年接受肺ADC根治手术的患者。DLCO值被分为DLCOlow（预测值的<80％）和DLCOnormal（≥80％）。评估了DLCO与ADC组织病理学特征、临床特征以及整体生存期（OS）之间的关系。共招募了460名患者，其中193名（42％）属于DLCOlow组。DLCOlow与吸烟状态、低FEV1、微小乳头状和实体ADC、肿瘤分级3级、高肿瘤淋巴组织浸润和肿瘤成纤维反应的存在有关。此外，DLCO值在低级别ADC中较高，并逐渐降低至中级和高级ADC（p=0.024）。在调整临床变量后，多元逻辑回归分析显示，DLCOlow仍与高淋巴组织浸润（p=0.017）、成纤维反应的存在（p=0.065）、肿瘤分级3级（p=0.062）、微小乳头状和实体ADC亚型（p=0.008）显示显著相关。为了排除非吸烟者和良好分化ADC之间的关联，确认了DLCO与组织病理学ADC模式之间的关系，子集为377名前烟民和现烟民（p=0.021）。在单变量分析中，性别、DLCO、FEV1、ADC组织学类型、肿瘤分级、肿瘤期、胸膜侵犯、肿瘤坏死、肿瘤成纤维反应、淋巴管和血液侵犯与OS显著相关。在多元分析中，只有性别（p＜0.001）、肿瘤期（p＜0.001）和DLCO（p=0.050）与OS显著相关。我们发现了DLCO与ADC模式之间的关系，以及与肿瘤分级、肿瘤淋巴组织浸润和成纤维反应的关系，提示肺损伤可能与肿瘤侵袭性有关。版权所有 © 2023 SEPAR。Elsevier España，S.L.U.出版。保留所有权利。

This study aimed to evaluate a potential relationship between the diffusing capacity of the lung for carbon monoxide (DLCO) and the aggressiveness of lung adenocarcinoma (ADC).Patients who underwent radical surgery for lung ADC between 2001 and 2018 were retrospectively reviewed. DLCO values were dichotomized into DLCOlow (<80% of predicted) and DLCOnormal (≥80%). Relationships between DLCO and ADC histopathological features, clinical features, as well as with overall survival (OS), were evaluated.Four-hundred and sixty patients were enrolled, of which 193 (42%) were included in the DLCOlow group. DLCOlow was associated with smoking status, low FEV1, micropapillary and solid ADC, tumour grade 3, high tumour lymphoid infiltrate and presence of tumour desmoplasia. In addition, DLCO values were higher in low-grade ADC and progressively decreased in intermediate and high-grade ADC (p=0.024). After adjusting for clinical variables, at multivariable logistic regression analysis, DLCOlow still showed a significant correlation with high lymphoid infiltrate (p=0.017), presence of desmoplasia (p=0.065), tumour grade 3 (p=0.062), micropapillary and solid ADC subtypes (p=0.008). To exclude the association between non-smokers and well-differentiated ADC, the relationship between DLCO and histopathological ADC patterns was confirmed in the subset of 377 former and current smokers (p=0.021). At univariate analysis, gender, DLCO, FEV1, ADC histotype, tumour grade, stage, pleural invasion, tumour necrosis, tumour desmoplasia, lymphatic and blood invasion were significantly related with OS. At multivariate analysis, only gender (p<0.001), tumour stage (p<0.001) and DLCO (p=0.050) were significantly related with the OS.We found a relationship between DLCO and ADC patterns as well as with tumour grade, tumour lymphoid infiltrate and desmoplasia, suggesting that lung damage may be associated with tumour aggressiveness.Copyright © 2023 SEPAR. Published by Elsevier España, S.L.U. All rights reserved.