特发性肺间质纤维化合并肺癌的临床分析

Clinical Analysis of Idiopathic Pulmonary Interstitial Fibrosis with Lung Cancer

目的对特发性肺间质纤维化合并肺癌的临床特征进行分析。方法方便选取2017年1月—2020年6月于该院接受治疗30例特发性肺间质纤维化合并肺癌患者作为观察组,另选取同期于该院接受治疗的30例单纯肺癌患者作为对照组。对两组患者的基本资料、临床表现、肿瘤指标、血气指标、影像学表现、肿瘤分期进行比较。结果观察组的男性占比高于对照组,平均年龄大于对照组,吸烟者占比大于对照组,差异有统计学意义(χ^(2)=6.238,t=18.613,χ^(2)=6.648,P<0.05);观察组的呼吸困难占比(63.33%)、杵状指占比(53.33%)均高于对照组(26.67%、6.67%),咯血、发热占比(20.00%、26.67%)均低于对照组(60.0%、56.67%),差异有统计学意义(χ^(2)=8.148、15.556、10.000、5.554,P<0.05);经比较两组的肿瘤指标,观察组与对照组的癌胚抗原、神经元特异性烯醇化酶、CY211、糖类抗原125、糖类抗原153对比,差异无统计学意义(t=0.896、0.426、1.185、0.549、0.215,P>0.05);经比较两组的血气指标,两组的氧分压指标差异无统计学意义(P>0.05),观察组的二氧化碳分压小于对照组,差异有统计学意义(P<0.05);经比较两组的影像学表现,观察组与对照组患者在位置和叶分布情况上比较,差异有统计学意义(P<0.05);经比较两组的肿瘤分期,观察组的Ⅰa-Ⅱb期占比低于对照组,Ⅲa~Ⅳ占比高于对照组,差异有统计学意义(P<0.05)。结论特发性肺间质纤维化合并肺癌患者以高龄、男性、吸烟者为主要患病人群,患者的血清学和影像学均有明显变化,因此,对于特发性肺间质纤维化合并肺癌患者要进行密切随访,治疗过程中要引起医护人员的高度关注。

Objective To analyze the clinical features of idiopathic pulmonary fibrosis with lung cancer.Methods From January 2017 to June 2020,30 patients with idiopathic pulmonary interstitial fibrosis and lung cancer were conveniently selected as the observation group,and 30 patients with simple lung cancer who received treatment in the hospital during the same period were selected as the control group.The basic data,clinical manifestations,tumor indicators,blood gas indicators,imaging manifestations,and tumor stages of the two groups were compared.Results The proportion of males,average age and proportion of smokers in the observation group were higher than those in the control group,and the differences were statistically significant(χ^(2)=6.238,t=18.613,χ^(2)=6.648,P<0.05).The proportions of dyspnea(63.33%)and clustle finger(53.33%)in the observation group were higher than those in the control group(26.67%,6.67%),and the proportions of hemoptysis and fever(20.00%,26.67%)were lower than those in the control group(60.0%,56.67%).The difference was statistically significant(χ^(2)=8.148,15.556,10.000,5.554,P<0.05);By the comparison of two groups of tumor marker,the observation group and control group of carcinoembryonic antigen,neuron specific enolization enzyme,CY211,carbohydrate antigen 125,carbohydrate antigen 153,there was no statistically significant difference(t=0.896,0.426,1.185,0.549,0.215,P>0.05);after comparing the blood gas indexes of the two groups,the difference of oxygen partial pressure indexes of the two groups was not statistically significant,and the carbon dioxide partial pressure of the observation group was less than that of the control group,the difference was statistically significant(P<0.05).By comparing the imaging manifestations of the two groups.In the position and leaf distribution between the observation group and the control group,the difference was statistically significant(P<0.05).By the comparison of two groups of tumor staging,observation groupⅠ-Ⅱb period ratio is lower than the control group,Ⅲa-Ⅳproportion is higher than the control group,the difference was statistically significant(P<0.05).Conclusion Patients with idiopathic pulmonary interstitial fibrosis with lung cancer are mainly elderly,men,and smokers.The serology and imaging of the patients have significant changes.Therefore,for idiopathic pulmonary fibrosis patients with lung cancer,they should be followed up closely,and medical staff should pay great attention to them during the treatment.