85例肺间质纤维化合并肺癌的临床特点及CT征象分析

Analysis of Clinical Characteristics and CT Signs in the 85 Cases with Interstitial Pulmonary Fibrosis and Lung Cancer

目的分析探讨肺间质纤维化(IPF)合并肺癌(LC)的临床特点及CT征象。方法选取2016年12月至2018年12月本院的IPF患者85例,根据其是否合并LC分为IPF组(不合并LC,n=45)和IPF-LC组(合并LC,n=40),观察比较两组一般资料差异,并对相关影响因素进行Logistic回归分析,绘制两组1年的生存曲线,比较两组1年死亡率;对IPF-LC组行肺部CT检查,观察其肺部CT征象。结果两组患者在吸烟史、呼吸困难、咳嗽、二氧化碳分压(PaCO_(2))、氧分压(PaO_(2))、癌胚抗原(CEA)、糖类抗原125(CA125)上差异明显(P<0.05);Logistic多因素回归分析结果显示,有吸烟史、呼吸困难、咳嗽、PaCO_(2)>50mmHg、PaO_(2)<75mmHg、CEA>5.9ng/mL、CA125>35U/mL是IPF合并LC独立危险因素。IPF-LC组1年内死亡率明显高于IPF组(P<0.05),生存曲线分析结果显示,IPF-LC组的1年内生存预后情况明显劣于IPF组。CT征象分析结果显示,IPF-LC组的癌灶多位于肺间质纤维化区,主要分布于双肺上叶。结论有吸烟史、呼吸困难、咳嗽、PaCO_(2)>50mmHg、PaO_(2)<75mmHg、CEA>5.9ng/mL、CA125>35U/mL的IPF患者更易并发LC,且IPF合并LC患者生存预后变差,其癌灶多分布于双肺上叶、肺间质纤维化区。

Objective To analyze the clinical characteristics and CT signs of interstitial pulmonary fibrosis(IPF)combined with lung cancer(LC).Methods A total of 85 patients with IPF in the hospital were enrolled between December 2016 to December 2018.According to presence or absence of LC,they were were divided into IPF-LC group(n=40)and IPF group(n=45).The differences in general data were observed and compared between the two groups.The related influencing factors were analyzed by Logistic regression analysis.The 1-year survival curves were drawn to compare 1-year mortality between the two groups.CT examination of lungs was conducted to observe CT signs in IPF-LC group.Results There were significant differences in smoking history,dyspnea,cough,partial pressure of carbon dioxide(PaCO_(2)),oxygen partial pressure(PaO_(2)),carcinoembryonic antigen(CEA)and carbohydrate antigen 125(CA125)between the two groups(P<0.05).The results of Logistic multivariate regression analysis showed that smoking history,dyspnea,cough,PaCO_(2)>50mmHg,PaO_(2)<75mmHg,CEA>5.9ng/mL and CA125>35U/mL were independent risk factors of IPF combined with LC.The 1-year mortality in IPF-LC group was significantly higher than that in IPF group(P<0.05).The results of survival curve analysis showed that 1-year survival prognosis in IPF-LC group was significantly worse than that in IPF group.The results of CT signs analysis showed that the cancer foci in IPF-LC group were mostly located in IPF area,mainly in the superior lobes of bilateral lungs.Conclusion IPF patients with smoking history,dyspnea,cough,PaCO_(2)>50mmHg,PaO_(2)<75mmHg,CEA>5.9ng/mL and CA125>35U/mL are prone to LC.The survival prognosis is worse in patients with IPF and LC,and their cancer foci are mostly distributed in superior lobes of bilateral lungs and IPF area.