特发性肺纤维化合并肺癌的临床特征及预后分析  

Clinical characteristics and prognosis of idiopathic pulmonary fibrosis complicated with lung cancer

作　　者：李子广[1] 芮艳 黄礼年[2] LI Zi-guang(Department of respiratory medicine,the second affiliated hospital of Bengbu Medical College,Bengbu,Anhui,233003,China)

机构地区：[1]蚌埠医学院第二附属医院呼吸内科,安徽蚌埠233000 [2]蚌埠医学院第一附属医院呼吸与危重症医学科,安徽蚌埠233004

出　　处：《齐齐哈尔医学院学报》2020年第15期1890-1892,共3页Journal of Qiqihar Medical University

摘　　要：目的探讨特发性肺纤维化(IPF)患者肺癌(LC)的发生率及其危险因素,了解IPF患者肺癌的临床、影像学及病理特点,分析患者的预后和影响因素。方法选取2013年4月—2018年11月入住本院诊断为IPF患者204例作为研究对象,将其分为IPF-LC组和IPF组两组,IPF-LC组23例经病理证实为肺癌(LC)患者,IPF组181例为间质性肺疾病(IPF)患者。分析IPF-LC患者的临床特征、影像学表现,并与单纯IPF患者进行比较;采用Cox回归模型分析多种临床因素对生存的影响,统计分析生存时间。结果204例IPF患者中,23例诊断为IPF合并LC,占11.3%。LC主要分布在肺外带和肺下叶;吸烟是IPF-LC发展的危险因素。两组患者的CEA和ProGRP水平比较,无明显差异(P>0.05);IPF-LC组患者血清SCC、CYFA21-1和NSE水平明显高于IPF组,差异有统计学意义(P<0.05)。结论IPF患者中LC的患病率为11.3%。IPF患者中常发生肺癌,以鳞癌为主。血清SCC、NSE、CYFA21-1水平是IPF患者发生肺癌的潜在指标,吸烟是IPF患者发生LC最重要的独立预测因素。发生LC的IPF患者的生存率较差。Objective To investigate the incidence of lung cancer in patients with idiopathic pulmonary fibrosis(idiopathic pulmonary fibrosis IPF)and its risk factors,to understand the clinical,imaging and pathological characteristics of lung cancer(lung cancer LC)in patients with IPF,and to analyze the prognosis and influencing factors.Methods We selected 204 patients those diagnosed as IPF in our hospital from April 1st,2013 to November 30th,2018 as study subjects.23 patients with pathologically proved lung cancer were divided into IPF-LC group,and the other 181 patients with interstitial lung disease were divided into IPF group.The clinical and imaging features of patients with IPF and LC were analyzed and compared with those patients with simple IPF.Cox regression model was used to analyze the influence of various clinical factors on survival,draw survival curves,and compare the effects of different clinical factors on prognosis.Results Among the 204 cases of IPF,23 cases were diagnosed as IPF with LC(11.3%).LC was mainly distributed in the peripheral area and the lower lobe of the lung.The smoking is risk factors for the development of IPF-LC.There was no significant difference in the levels of CEA and ProGRP between the two groups(p>0.05).The levels of SCC,NSE and CYFA21-1 in IPF patients with lung cancer were significantly higher than those in IPF patients(P<0.05).Conclusions The prevalence of LC in IPF patients is 11.3%.Lung cancer is common in patients with IPF,and squamous cell carcinoma is the most common.Serum levels of SCC,NSE and CYFA21-1 are potential indicators of lung cancer in patients with IPF.Smoking is the most important independent predictor of LC in patients with IPF.A poorer survival was observed for patients with IPF developing LC.

关 键 词：间质性肺纤维化 肺癌 临床特征 预后 

分 类 号：R563.9[医药卫生—呼吸系统]