{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,26]],"date-time":"2026-03-26T11:19:58Z","timestamp":1774523998797,"version":"3.50.1"},"reference-count":38,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2026,2,19]],"date-time":"2026-02-19T00:00:00Z","timestamp":1771459200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0"},{"start":{"date-parts":[[2026,3,26]],"date-time":"2026-03-26T00:00:00Z","timestamp":1774483200000},"content-version":"vor","delay-in-days":35,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0"}],"funder":[{"DOI":"10.13039\/501100001809","name":"the National Natural Science Foundation of China","doi-asserted-by":"crossref","award":["82071873"],"award-info":[{"award-number":["82071873"]}],"id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"crossref"}]},{"name":"Shanghai Science and Technology Innovation Action Plan","award":["22Y11911100"],"award-info":[{"award-number":["22Y11911100"]}]},{"name":"Shanghai Innovative Medical Product Application Demonstration Project","award":["24SF1904000"],"award-info":[{"award-number":["24SF1904000"]}]},{"name":"Shanghai Health Research Foundation for Talents","award":["2022YQ060"],"award-info":[{"award-number":["2022YQ060"]}]},{"DOI":"10.13039\/501100020771","name":"Young Scientists Fund of the National Natural Science Foundation of China","doi-asserted-by":"crossref","award":["82302188"],"award-info":[{"award-number":["82302188"]}],"id":[{"id":"10.13039\/501100020771","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["BMC Med Imaging"],"DOI":"10.1186\/s12880-026-02229-y","type":"journal-article","created":{"date-parts":[[2026,2,19]],"date-time":"2026-02-19T06:06:34Z","timestamp":1771481194000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["The impact of chest computed tomography-defined emphysema on extrapulmonary metastases in patients with lung cancer"],"prefix":"10.1186","volume":"26","author":[{"given":"Yunjing","family":"Zhu","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Qunhui","family":"Chen","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Huiyuan","family":"Zhu","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kai","family":"Nie","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Li","family":"Zhu","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lingming","family":"Yu","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Guangyu","family":"Tao","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jun","family":"Xing","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shaojie","family":"Li","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yanbing","family":"Sun","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Qiming","family":"Ni","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Weizheng","family":"Kong","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hong","family":"Yu","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lin","family":"Zhu","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2026,2,19]]},"reference":[{"issue":"3","key":"2229_CR1","doi-asserted-by":"publisher","first-page":"209","DOI":"10.3322\/caac.21660","volume":"71","author":"H Sung","year":"2021","unstructured":"Sung H, Ferlay J, Siegel RL, Laversanne M, Soerjomataram I, Jemal A, et al. Global cancer statistics 2020: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. Ca-Cancer J Clin. 2021;71(3):209\u201349.","journal-title":"Ca-Cancer J Clin"},{"issue":"5","key":"2229_CR2","doi-asserted-by":"publisher","first-page":"457","DOI":"10.1007\/s10585-019-09985-y","volume":"36","author":"J Yang","year":"2019","unstructured":"Yang J, Peng AM, Wang B, Gusdon AM, Sun XT, Jiang GN, et al. The prognostic impact of lymph node metastasis in patients with non-small cell lung cancer and distant organ metastasis. Clin Exp Metastas. 2019;36(5):457\u201366.","journal-title":"Clin Exp Metastas"},{"issue":"10066","key":"2229_CR3","doi-asserted-by":"publisher","first-page":"299","DOI":"10.1016\/S0140-6736(16)30958-8","volume":"389","author":"FR Hirsch","year":"2017","unstructured":"Hirsch FR, Scagliotti GV, Mulshine JL, Kwon R, Curran WJ, Wu YL, et al. Lung cancer: current therapies and new targeted treatments. Lancet. 2017;389(10066):299\u2013311.","journal-title":"Lancet"},{"issue":"2","key":"2229_CR4","doi-asserted-by":"publisher","first-page":"92","DOI":"10.1056\/NEJMoa011954","volume":"346","author":"JH Schiller","year":"2002","unstructured":"Schiller JH, Harrington D, Belani CP, Langer C, Sandler A, Krook J, et al. Comparison of four chemotherapy regimens for advanced non-small-cell lung cancer. New Engl J Med. 2002;346(2):92\u20138.","journal-title":"New Engl J Med"},{"issue":"8","key":"2229_CR5","doi-asserted-by":"publisher","first-page":"6787","DOI":"10.21037\/qims-2025-142","volume":"15","author":"Y Zhu","year":"2025","unstructured":"Zhu Y, Liu J, Nie K, Chen Q, Yu L, Zhang Y, et al. Added value of abdominal CT after treatment of lung cancer. Quant Imaging Med Surg. 2025;15(8):6787\u2013800.","journal-title":"Quant Imaging Med Surg"},{"issue":"11","key":"2229_CR6","doi-asserted-by":"publisher","first-page":"1515","DOI":"10.1097\/JTO.0000000000000673","volume":"10","author":"WEE Eberhardt","year":"2015","unstructured":"Eberhardt WEE, Mitchell A, Crowley J, Kondo H, Kim YT, Turrisi A, et al. The IASLC lung cancer staging project. J Thorac Oncol. 2015;10(11):1515\u201322.","journal-title":"J Thorac Oncol"},{"issue":"9","key":"2229_CR7","doi-asserted-by":"publisher","first-page":"1180","DOI":"10.1016\/S1470-2045(22)00451-X","volume":"23","author":"V Westeel","year":"2022","unstructured":"Westeel V, Foucher P, Scherpereel A, Domas J, Girard P, Tredaniel J, et al. Chest CT scan plus x-ray versus chest x-ray for the follow-up of completely resected non-small-cell lung cancer (IFCT-0302) a multicentre, open-label, randomised, phase 3 trial. Lancet Oncol. 2022;23(9):1180\u20138.","journal-title":"Lancet Oncol"},{"issue":"11","key":"2229_CR8","doi-asserted-by":"publisher","first-page":"1013","DOI":"10.1016\/S2213-2600(22)00302-2","volume":"10","author":"A Agusti","year":"2022","unstructured":"Agusti A, Vogelmeier CF, Halpin DMG. Tackling the global burden of lung disease through prevention and early diagnosis. Lancet Respiratory Med. 2022;10(11):1013\u20135.","journal-title":"Lancet Respiratory Med"},{"issue":"1","key":"2229_CR9","doi-asserted-by":"publisher","first-page":"18","DOI":"10.1016\/S2213-2600(22)00494-5","volume":"11","author":"P Venkatesan","year":"2023","unstructured":"Venkatesan P. GOLD COPD report: 2023 update. Lancet Respir Med. 2023;11(1):18.","journal-title":"Lancet Respir Med"},{"issue":"5","key":"2229_CR10","doi-asserted-by":"publisher","first-page":"447","DOI":"10.1016\/S2213-2600(21)00511-7","volume":"10","author":"D Adeloye","year":"2022","unstructured":"Adeloye D, Song P, Zhu Y, Campbell H, Sheikh A, Rudan I, et al. Global, regional, and National prevalence of, and risk factors for, chronic obstructive pulmonary disease (COPD) in 2019: a systematic review and modelling analysis. Lancet Respir Med. 2022;10(5):447\u201358.","journal-title":"Lancet Respir Med"},{"issue":"6","key":"2229_CR11","doi-asserted-by":"publisher","first-page":"1326","DOI":"10.1016\/j.chest.2018.01.049","volume":"153","author":"LL Carr","year":"2018","unstructured":"Carr LL, Jacobson S, Lynch DA, Foreman MG, Flenaugh EL, Hersh CP, et al. Features of COPD as predictors of lung cancer. Chest. 2018;153(6):1326\u201335.","journal-title":"Chest"},{"issue":"2","key":"2229_CR12","doi-asserted-by":"publisher","first-page":"380","DOI":"10.1183\/09031936.00144208","volume":"34","author":"RP Young","year":"2009","unstructured":"Young RP, Hopkins RJ, Christmas T, Black PN, Metcalf P, Gamble GD. COPD prevalence is increased in lung cancer, independent of age, sex and smoking history. Eur Respir J. 2009;34(2):380\u20136.","journal-title":"Eur Respir J"},{"issue":"2","key":"2229_CR13","doi-asserted-by":"publisher","first-page":"240","DOI":"10.1016\/j.canlet.2016.09.002","volume":"382","author":"C Mouronte-Roibas","year":"2016","unstructured":"Mouronte-Roibas C, Leiro-Fernandez V, Fernandez-Villar A, Botana-Rial M, Ramos-Hernandez C, Ruano-Ravina A. COPD, emphysema and the onset of lung cancer. A systematic review. Cancer Lett. 2016;382(2):240\u20134.","journal-title":"Cancer Lett"},{"issue":"7","key":"2229_CR14","doi-asserted-by":"publisher","first-page":"690","DOI":"10.1136\/thorax-2022-219334","volume":"78","author":"RP Young","year":"2023","unstructured":"Young RP, Ward RC, Scott RJ, Gamble GD, Silvestri G. Airflow limitation and mortality during cancer screening in the National lung screening trial: why quantifying airflow limitation matters. Thorax. 2023;78(7):690\u20137.","journal-title":"Thorax"},{"issue":"7225","key":"2229_CR15","first-page":"36","volume":"457","author":"A Mantovani","year":"2009","unstructured":"Mantovani A, Cancer. Inflaming Metastasis Nat. 2009;457(7225):36\u20137.","journal-title":"Inflaming Metastasis Nat"},{"issue":"1","key":"2229_CR16","doi-asserted-by":"publisher","first-page":"8","DOI":"10.1016\/j.ejcts.2004.09.010","volume":"27","author":"A Lopez-Encuentra","year":"2005","unstructured":"Lopez-Encuentra A, Astudillo J, Cerezal J, Gonzalez-Aragoneses F, Novoa N, Sanchez-Palencia A, et al. Prognostic value of chronic obstructive pulmonary disease in 2994 cases of lung cancer. Eur J Cardiothorac Surg. 2005;27(1):8\u201313.","journal-title":"Eur J Cardiothorac Surg"},{"issue":"12","key":"2229_CR17","doi-asserted-by":"publisher","first-page":"3652","DOI":"10.1109\/TMI.2021.3094660","volume":"40","author":"J Yang","year":"2021","unstructured":"Yang J, Angelini ED, Balte PP, Hoffman EA, Austin JHM, Smith BM, et al. Novel subtypes of pulmonary emphysema based on Spatially-Informed lung texture learning: the Multi-Ethnic study of atherosclerosis (MESA) COPD study. Ieee T Med Imaging. 2021;40(12):3652\u201362.","journal-title":"Ieee T Med Imaging"},{"key":"2229_CR18","doi-asserted-by":"crossref","unstructured":"Zuo ZC, Fan XH, Tang Y, Zhang Y, Peng X, Zeng WH, et al. Deep learning-powered 3D segmentation derives factors associated with lymphovascular invasion and prognosis in clinical T1 stage non-small cell lung cancer. Heliyon. 2023;9(4).","DOI":"10.1016\/j.heliyon.2023.e15147"},{"key":"2229_CR19","doi-asserted-by":"crossref","unstructured":"Zhang Y, Yi J, Sun D, Su Y, Zuo Y, Zhu M, et al. The association of chest computed tomography-defined visual emphysema and prognosis in patients with nonsmall cell lung cancer. Erj Open Res. 2023;9(6).","DOI":"10.1183\/23120541.00195-2023"},{"issue":"2","key":"2229_CR20","doi-asserted-by":"publisher","first-page":"322","DOI":"10.1148\/radiol.212904","volume":"304","author":"XF Yang","year":"2022","unstructured":"Yang XF, Wisselink HJ, Vliegenthart R, Heuvelmans MA, Groen HJM, Vonder M, et al. Association between chest CT-defined emphysema and lung cancer: A systematic review and Meta-Analysis. Radiology. 2022;304(2):322\u201330.","journal-title":"Radiology"},{"key":"2229_CR21","doi-asserted-by":"crossref","unstructured":"Agusti A, Celli BR, Criner GJ, Halpin D, Anzueto A, Barnes P, et al. Global initiative for chronic obstructive lung disease 2023 report: GOLD executive summary. Eur Respir J. 2023;61(4).","DOI":"10.1183\/13993003.00239-2023"},{"issue":"5","key":"2229_CR22","doi-asserted-by":"publisher","first-page":"1812","DOI":"10.1016\/j.chest.2020.12.004","volume":"159","author":"WW Labaki","year":"2021","unstructured":"Labaki WW, Xia M, Murray S, Hatt CR, Al-Abcha A, Ferrera MC, et al. Quantitative emphysema on Low-Dose CT imaging of the chest and risk of lung cancer and airflow obstruction: an analysis of the National lung screening trial. Chest. 2021;159(5):1812\u201320.","journal-title":"Chest"},{"issue":"1","key":"2229_CR23","doi-asserted-by":"publisher","first-page":"192","DOI":"10.1148\/radiol.2015141579","volume":"277","author":"DA Lynch","year":"2015","unstructured":"Lynch DA, Austin JH, Hogg JC, Grenier PA, Kauczor HU, Bankier AA, et al. CT-Definable subtypes of chronic obstructive pulmonary disease: A statement of the Fleischner society. Radiology. 2015;277(1):192\u2013205.","journal-title":"Radiology"},{"issue":"5","key":"2229_CR24","doi-asserted-by":"publisher","first-page":"3115","DOI":"10.1007\/s00330-023-09504-4","volume":"33","author":"M Mascalchi","year":"2023","unstructured":"Mascalchi M, Romei C, Marzi C, Diciotti S, Picozzi G, Pistelli F, et al. Pulmonary emphysema and coronary artery calcifications at baseline LDCT and long-term mortality in smokers and former smokers of the ITALUNG screening trial. Eur Radiol. 2023;33(5):3115\u201323.","journal-title":"Eur Radiol"},{"key":"2229_CR25","doi-asserted-by":"crossref","unstructured":"Varma S, Simon R. Bias in error Estimation when using cross-validation for model selection. BMC Bioinformatics. 2006;7.","DOI":"10.1186\/1471-2105-7-91"},{"issue":"2","key":"2229_CR26","doi-asserted-by":"publisher","first-page":"346","DOI":"10.1378\/chest.13-1176","volume":"145","author":"RH Zhai","year":"2014","unstructured":"Zhai RH, Yu XJ, Shafer A, Wain JC, Christiani DC. The impact of coexisting COPD on survival of patients with Early-Stage Non-small cell lung cancer undergoing surgical resection. Chest. 2014;145(2):346\u201353.","journal-title":"Chest"},{"key":"2229_CR27","first-page":"3767","volume":"13","author":"W Wang","year":"2018","unstructured":"Wang W, Dou S, Dong WY, Xie MS, Cui LW, Zheng CY, et al. Impact of COPD on prognosis of lung cancer: from a perspective on disease heterogeneity. Int J Chronic Obstr. 2018;13:3767\u201376.","journal-title":"Int J Chronic Obstr"},{"issue":"8","key":"2229_CR28","doi-asserted-by":"publisher","first-page":"5055","DOI":"10.1245\/s10434-024-15126-x","volume":"31","author":"M Ishida","year":"2024","unstructured":"Ishida M, Mimae T, Kamigaichi A, Kawamoto N, Tsubokawa N, Miyata Y, et al. The role of emphysema on postoperative prognosis in Early-Stage nonsmall cell lung cancer. Ann Surg Oncol. 2024;31(8):5055\u201363.","journal-title":"Ann Surg Oncol"},{"issue":"4","key":"2229_CR29","doi-asserted-by":"publisher","first-page":"389","DOI":"10.1111\/crj.13144","volume":"14","author":"K Wu","year":"2020","unstructured":"Wu K, Wang J, Zhao LM, Wang P, Duan Q. The prognosis of non-small cell lung cancer combined with chronic obstructive pulmonary disease: A systematic review and meta-analysis. Clin Respiratory J. 2020;14(4):389\u201396.","journal-title":"Clin Respiratory J"},{"issue":"6","key":"2229_CR30","doi-asserted-by":"publisher","first-page":"812","DOI":"10.1097\/JTO.0000000000000158","volume":"9","author":"SJ Lee","year":"2014","unstructured":"Lee SJ, Lee J, Park YS, Lee CH, Lee SM, Yim JJ, et al. Impact of chronic obstructive pulmonary disease on the mortality of patients with Non-Small-Cell lung cancer. J Thorac Oncol. 2014;9(6):812\u20137.","journal-title":"J Thorac Oncol"},{"key":"2229_CR31","doi-asserted-by":"crossref","unstructured":"Jin LL, Zhou SL, Huang L, He YT, Zhang JY, Chen L, et al. Neutrophil-to-lymphocyte ratio as a prognostic marker for lung cancer in combined pulmonary fibrosis and emphysema patients. Eur J Med Res. 2025;30(1).","DOI":"10.1186\/s40001-025-02595-3"},{"key":"2229_CR32","doi-asserted-by":"crossref","unstructured":"Jeong B, Lee SM, Park S, Choe J, Choi S, Do KH, et al. Prognostic performance in lung cancer according to tumor size: comparison of axial, multiplanar, and 3-dimensional CT measurement to pathological size. Eur J Radiol. 2021;144.","DOI":"10.1016\/j.ejrad.2021.109976"},{"issue":"4","key":"2229_CR33","doi-asserted-by":"publisher","first-page":"249","DOI":"10.6004\/jnccn.2204.0023","volume":"22","author":"GJ Riely","year":"2024","unstructured":"Riely GJ, Wood DE, Ettinger DS, Aisner DL, Akerley W, Bauman JR, et al. Non-Small cell lung Cancer, version 4.2024, NCCN clinical practice guidelines in oncology. J Natl Compr Canc Netw. 2024;22(4):249\u201374.","journal-title":"J Natl Compr Canc Netw"},{"issue":"2","key":"2229_CR34","doi-asserted-by":"publisher","first-page":"327","DOI":"10.1016\/j.chest.2023.01.034","volume":"164","author":"Y Shiraishi","year":"2023","unstructured":"Shiraishi Y, Tanabe N, Shimizu K, Oguma A, Shima H, Sakamoto R, et al. Stronger associations of centrilobular than paraseptal emphysema with longitudinal changes in diffusing capacity and mortality in COPD. Chest. 2023;164(2):327\u201338.","journal-title":"Chest"},{"issue":"7","key":"2229_CR35","doi-asserted-by":"publisher","first-page":"3941","DOI":"10.1245\/s10434-020-09362-0","volume":"28","author":"ZC Zuo","year":"2021","unstructured":"Zuo ZC, Zhang GC, Song P, Yang J, Li ST, Zhong Z, et al. Survival nomogram for stage IB Non-Small-Cell lung cancer Patients, based on the SEER database and an external validation cohort. Ann Surg Oncol. 2021;28(7):3941\u201350.","journal-title":"Ann Surg Oncol"},{"key":"2229_CR36","doi-asserted-by":"crossref","unstructured":"Zuo ZC, Zhang GC, Lin SY, Xue Q, Qi WY, Zhang W, et al. Radiomics nomogram based on optimal volume of interest derived from High-Resolution CT for preoperative prediction of IASLC grading in clinical IA lung adenocarcinomas: A Multi-Center, Large-Population study. Technol Cancer Res T. 2024;23.","DOI":"10.1177\/15330338241300734"},{"key":"2229_CR37","doi-asserted-by":"crossref","unstructured":"Ester M, Kriegel HP, Xu X, XGBoost. A scalable tree boosting system. In Proceedings of the 22Nd ACM SIGKDD International Conference on Knowledge Discovery and Data Miningvol, pg 785, (2016). Geogr Anal. 2022.","DOI":"10.1145\/2939672.2939785"},{"key":"2229_CR38","doi-asserted-by":"crossref","unstructured":"Ding L, Wang K, Zhang C, Zhang Y, Wang KLR, Li W, et al. A machine learning algorithm for predicting the risk of developing to M1b stage of patients with germ cell testicular cancer. Front Public Health. 2022;10.","DOI":"10.3389\/fpubh.2022.916513"}],"container-title":["BMC Medical Imaging"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/article\/10.1186\/s12880-026-02229-y","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s12880-026-02229-y.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s12880-026-02229-y.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,3,26]],"date-time":"2026-03-26T10:44:37Z","timestamp":1774521877000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/10.1186\/s12880-026-02229-y"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,2,19]]},"references-count":38,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2026,12]]}},"alternative-id":["2229"],"URL":"https:\/\/doi.org\/10.1186\/s12880-026-02229-y","relation":{},"ISSN":["1471-2342"],"issn-type":[{"value":"1471-2342","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,2,19]]},"assertion":[{"value":"2 September 2025","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"10 February 2026","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"19 February 2026","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"This study was conducted in accordance with the Declaration of Helsinki and its subsequent amendments. The retrospective study was approved by the Shanghai Chest Hospital review board (No. KS1956) and the requirement for informed consent was waived.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"Not applicable.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"The authors declare no competing interests.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"157"}}