特发性肺间质纤维化合并肺癌的临床及影像学特点分析.docVIP

特发性肺间质纤维化合并肺癌的临床及影像特点分析 周勇，周华，沈茜，潘志杰，姚亚克，周建英 【摘要】 目的 了解特发性肺间质纤维化（idiopathic pulmonary fibrosis, IPF）合并肺癌（Lung Cancer, LC）的临床及影像学特点。方法 回顾性分析（2009年4月- 2014年4月）浙江大学医学院附属第一医院21例诊断为特发性肺间质纤维化合并肺癌（IPF-LC）患者临床、影像学特点等。并与同期的23例单纯特发性肺间质纤维化（IPF-only）进行比较。结果 21例患者，平均年龄65.2岁，平均吸烟指数43.1包·年，临床表现包括：干咳（18/21），气促（15/21），咯血（4/21）；病理类型以鳞癌（11/21）、腺癌（7/21）为主。肺癌好发于两肺下叶（14/21）外周带（17/21），多不与蜂窝样结构相邻（5/21），且均为实性占位（21/21）。与同期IPF-only进行比较，发现IPF-LC组患者普遍年龄更大，低氧血症常见，吸烟指数更高。结论 IPF患者CT上新出现占位需警惕肿瘤的可能。吸烟、男性及低氧血症与IPF - LC存在相关性，并影响预后。 【关键词】特发性肺间质纤维化；肺癌；吸烟 Clinical and Imaging Characteristics of Idiopathic Pulmonary Fibrosis Combined with Lung Cancer ZHOU Yong*, ZHOU Hua, SHEN Qian, Pan Zhijie, YAO Yake, ZHOU Jianying. Department of Respiratory Medcine, The First Affiliated Hospital, Zhejiang University School Of Medcine, Hangzhou 310003, China Corresponding author: ZHOU Jianying, Email: zjyhz@zju.edu.cn ______________________________ 作者单位：310003 杭州，浙江大学医学院附属第一医院呼吸科，第一作者现在宁波市第二医院呼吸科，315000 通信作者Email: zjyhz@zju.edu.cn 基金项目：浙江省科技专项重大社会发展项目（2012C13022-2）；浙江省中医药科学研究基金计划（2010ZB059） 【Abstract】Objective: To study the clinical and imaging features of idiopathic pulmonary fibrosis combined with lung cancer (IPF-LC). Methods: Twenty-one patients with IPF-LC were retrospectively reviewed between April 2009 and April 2014 in The First Affiliated Hospital, Zhejiang University School of Medcine. Their clinical features，chest radiography，pathology，prognosis were analyzed. Compared with twenty-three patients with IPF-only at the same period (April 2009 and April 2014). Results: The mean age was 65.2 years. There were 20 males and 1 female. The average smoking index was 43.1 pack-years. The clinical presentations included cough (18/21), shortness of breath (15/21), and hemoptysis (4/21). The cardinal cell types were squamous carcinoma (11/21) and adenocarcinoma (7/21). The cancer was mostly located in the periphery (17/21) of the lower lobe (14/21), which was seldom located near the honeycomb area (5/21), and all of them