特发性肺间质纤维化合并肺癌的临床和影像特点分析

发布时间：2018-05-14 14:18

本文选题：特发性肺间质纤维化 + 肺癌　；参考：《浙江大学》2016年硕士论文

【摘要】：目的了解特发性肺间质纤维化(IPF)合并肺癌(IPF-LC)的临床和影像学特点。方法回顾性分析2009年4月—2014年4月在浙江大学医学院附属第一医院住院期间诊断为IPF-LC的21例患者(IPF-LC组)的临床、影像学特点,并与同期的23例单纯IPF患者(单纯IPF组)进行比较。结果IPF-LC组患者平均年龄为(65.2±10.1)岁,平均吸烟指数为(43.1±27.6)包·年,临床表现为咳嗽、咳痰15例(71%),气促18例(86%),咯血4例(19%),肿瘤病理类型以鳞癌11例(52%),腺癌7例(33%)为主,好发于两肺下叶(67%)和外周带(81%),多与网格状、蜂窝样结构不相邻(76%),且均为实性占位(100%)。IPF-LC组的男性患者比例和吸烟指数均显著高于单纯IPF组(P值分别0.05、0.01),SaO2水平显著低于单纯IPF组(P0.05),生存时间显著短于单纯IPF组(P0.05)。综合21例IPF-LC患者的年龄、是否吸烟、肿瘤分期、血肿瘤标志物(血癌胚抗原、血糖类抗原199)、动脉血氧分压(Sa02)等进行18个月生存率的Cox比例风险回归模型分析,结果提示除吸烟、低氧血症外(P值均0.05),其余各因素与生存率均不相关(P值均0.05)。综合两组IPF患者(包括21例IPF-LC和23例单纯IPF)的年龄、是否吸烟、血肿瘤标志物(血癌胚抗原、血糖类抗原199)、Sa02、是否合并肿瘤等进行18个月生存率的Cox比例风险回归模型分析,结果提示合并肿瘤患者预后差(P0.05),余各因素与生存率均不相关(P值均0.05)。结论IPF患者CT上新出现占位需警惕肿瘤的可能。是否合并肺癌影响IPF患者的预后,而吸烟、低氧血症与IPF-LC患者生存率存在相关性。
[Abstract]:Objective to investigate the clinical and imaging features of idiopathic pulmonary interstitial fibrosis (IPF) combined with lung cancer (IPF-LC). Methods the clinical and imaging features of 21 patients with IPF-LC diagnosed in the first affiliated Hospital of Zhejiang University Medical College from April 2009 to April 2014 were retrospectively analyzed. The results were compared with 23 patients with IPF alone (IPF group) in the same period. Results the average age of patients in IPF-LC group was 65.2 卤10.1 years, and the average smoking index was 43.1 卤27.6 years. The clinical manifestations were cough, sputum in 15 cases, sputum in 71 cases, dyspnea in 18 cases, hemoptysis in 4 cases, squamous cell carcinoma in 11 cases and adenocarcinoma in 7 cases. Most often occurring in the lower lobe of both lungs) and in the peripheral zone of 81C, mostly gridded. The percentage and smoking index of male patients with nonadjacent honeycomb structure were significantly higher than that of IPF group (P = 0.050.01), respectively, and the survival time was significantly shorter than that of IPF group (P 0.05). Age, smoking, tumor stage, blood tumor markers (carcinoembryonic antigen, carbohydrate antigen 199g, arterial oxygen partial pressure Sa02) of 21 patients with IPF-LC were analyzed by Cox proportional regression model. The results showed that smoking was excluded. All the other factors were not correlated with survival rate (P = 0.05). The age, smoking, tumor markers (carcinoembryonic antigen, carbohydrate antigen 199-Sa02, tumor associated with tumor) of the two groups of IPF patients (including 21 cases of IPF-LC and 23 cases of simple IPF) were analyzed by using the Cox proportional risk regression model for the survival rate of 18 months. The results suggested that the prognosis of patients with tumor was poor (P 0.05), and the other factors were not correlated with survival rate (P = 0.05). Conclusion the new occurrences on CT in IPF patients need to be alert to the possibility of tumor. The prognosis of patients with IPF was affected by lung cancer, while smoking and hypoxemia were associated with survival rate of IPF-LC patients.
【学位授予单位】：浙江大学
【学位级别】：硕士
【学位授予年份】：2016
【分类号】：R563;R734.2

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