肺纤维化并肺癌患者的临床特征及相关危险因素的分析

The features and increased risks of lung cancer in patients with idiopathic pulmonary fibrosis

目的 熟悉肺纤维化并肺癌 (IPF Ca)患者的临床特征及相关危险因素 ,了解肺纤维化 (IPF)与肺癌发病之间的关系。方法 回顾性分析患者的临床特征 ,以及胸部CT、肺活检的病理类型等表现。受实验者包括 2 8例肺纤维化合并有肺癌的患者 ,4 8例仅有肺纤维化患者 ,5 70例仅有肺癌的患者 ,所有的患者均在同一时期符合中华结核与呼吸杂志制订的诊断标准。结果 年龄、性别、吸烟等危险因素 ,在肺纤维化并肺癌组与单独的肺纤维化、肺癌组比较中明显增高 ;IPF Ca的常见细胞类型为磷状细胞癌 ,与普通的肺癌细胞类型比较 ,没有明显不同。在一些情况下 ,肺纤维化区域可发展为肺癌 ,胸部CT上肺纤维化与肺癌的一致率有 36 %。结论 本研究提示年龄、性别、吸烟等均为IPF Ca的危险因素 ,与肺纤维化及肺癌的危险因素相关 ,在肺纤维化并肺癌的患者中与总的肺癌比较 ,肿瘤的细胞类型及特征没有不同 。

Objective To become familiar with the features and increased risks of lung cancer in patients with idiopathic pulmonary fibrosis ,and to investigate the direct relationship between fibrosis and cancer development .Methods The retrospective study was made on the clinical course of patients.The real concordance rate of the two lesions in the chest computed tomography (CT ) was analysed and compared to the histological types of lung cancer.The subjects included 28 patients with combined lung cancer and IPF (IPF Ca ) ,48 patients with lone IPF ,and 570 patients with primary lung cancer .All patients were campatible with the diagnostic criteria drawn up by zhong hua hu xi yujie he za zhi during the same period .Results The age ,percentage of smokers ,and the male sex were significantly higher in IPF Ca compared with lone IPF .The most frequent cell type was squamous cell carcinoma, and there was no significant difference in the cancer cell type between IPF Ca and total lung cancer population . In some situation ,the cancer might develop in the area of major fibrosis .IPF Ca was founded to be frequent in the periphery of the lung and the lower lobe,the real concordance rate of the two lesions in the chest computed tomography (CT ) was 36%.Conclusion These findings suggest that not only the age , smoking ,but also the male sex is a strong risk factor for IPF Ca . IPF is assocated with increased risk of lung cancer. the features of IPF Ca are similar to the total lung cancer population.The occurrence of IPE may be certainly correlated with the early action of lung cancer.