不同病理类型的肺癌合并慢性阻塞性肺疾病的临床特征及对患者预后的提示意义

Clinical relationship between chronic obstructive pulmonary disease and pathological types of lung cancer and suggestive implications for patient prognosis

目的探讨不同病理类型的肺癌合并慢性阻塞性肺疾病的临床特征,探索其对患者预后存在的提示意义。方法回顾性分析2019年1月至2021年8月就诊的200例肺癌患者分为两组:肺癌合并COPD组(100例)和肺癌组(100例)。对比分析两组的病理特征、发生率、治疗方式及预后情况。结果两组患者全部随访成功。肺癌组与肺癌合并COPD组患者在胸痛、呼吸困难、胸腔积液、FVE1/FVC及坏死区域ADC值等方面的差异有统计学差异(P<0.05)。肺癌组的存活率、PFSE和OS均明显高于肺癌合并COPD组(P<0.05)。Logstic回归分析结果显示,胸腔积液、FEV1%FVC、胸痛、吸烟史和坏死区域ADC值偏高等均是发生肺癌合并COPD的危险因素(P<0.05)肺癌合并COPD组共收集小细胞肺癌24例,肺鳞癌48例、肺腺癌28例。各组患者的治疗情况和1年内随访期间死亡率、早期肺癌复发转移率及癌症控制率等预后情况对比,数据差异存在统计学意义(P<0.05)。结论慢性阻塞性肺疾病与肺癌病理类型密切相关。不同病理类型肺癌与慢性阻塞性肺疾病临床早期症状体征不同,联合治疗COPD和肺癌,有助于改善慢性阻塞性肺疾病合并肺癌预后。

Objective to explore the clinical characteristics of different pathological types of lung cancer complicated with chronic obstructive pulmonary disease(COPD),and to explore its significance for prognosis.Methods the clinical data of 200 patients with chronic airway inflammatory diseases from January 2021 to August 2023 were retrospectively analyzed.According to the presence or absence of lung cancer,the patients were divided into two groups:COPD with lung cancer group and COPD group.The pathological features,incidence,treatment and prognosis of the two groups were compared and analyzed.Results All patients in both groups were followed up successfully.There were significant differences in chest pain,dyspnea,pleural effusion,FVE1/FVC and ADC value of necrotic area between lung cancer group and lung cancer complicated with COPD group(P<0.05).The survival rate,PFSE and OS of lung cancer group were significantly higher than those of lung cancer combined with COPD group(P<o.05).Logstic regression analysis showed that pleural effusion,FVE1/FVC,chest pain,smoking history and high ADC value in necrotic area were all risk factors for lung cancer complicated with COPD(P<0.05).There were statistical differences between the treatment of the three groups and the prognosis of mortality,recurrence and metastasis rate of early lung cancer and cancer control rate during the one-year follow-up period(P<0.05).Conclusion chronic obstructive pulmonary disease is closely relat-ed to the pathological type of lung cancer.Different pathological types of lung cancer and chronic obstructive pulmonary disease have different early clinical symptoms and signs.Combined treatment of COPD and lung cancer is helpful to im-prove the prognosis of chronic obstructive pulmonary disease complicated with lung cancer.