结缔组织病相关间质性肺病合并肺癌16例临床分析
Clinical analysis of 16 cases of connective tissue disease-associated interstitial lung disease complicated with lung cancer
张国华 1张令令 1高兰 1罗俊丽 1申雅文 1刘磊 2王玉华1
作者信息
- 1. 首都医科大学附属北京世纪坛医院风湿免疫科(邮编 100038)
- 2. 首都医科大学附属北京世纪坛医院科技处(邮编 100038)
- 折叠
摘要
目的 对16例结缔组织病相关间质性肺病(CTD-ILD)合并肺癌患者的临床特点进行分析,以提高对该类疾病的认知.方法 回顾性分析住院治疗的CTD-ILD合并肺癌的16例患者的临床资料,包括一般资料、临床表现、辅助检查、肺癌病理分型、TNM分期、治疗及预后.结果 16例CTD-ILD合并肺癌患者中男12例,女4例;CTD-ILD确诊时平均年龄(64.7±9.2)岁,肺癌确诊时平均年龄(66.6±8.7)岁.合并肺癌患者以影像学发现肺占位(62.5%)为最常见的首发症状,其次为咳嗽咳痰、胸痛(各占12.5%).肺癌病理类型以腺癌(8例,50.0%)最常见,其次为小细胞肺癌(4例,25.0%).CTD-ILD确诊时间早于肺癌者(8例,50.0%)最常见,中位时间36.0(11.3,57.0)个月,其次为同时确诊者7例(43.8%),CTD-ILD确诊时间晚于肺癌者1例(6.3%).肺癌TNM分期以Ⅳ期(9例,56.25%)最常见.16例患者随访1～64个月,中位时间8.5(1.5,14.3)个月;11例(68.8%)死亡,8例(72.7%)死于感染,3例(27.3%)死于终末期肺癌.结论 对于CTD-ILD患者需密切随访,定期进行影像学的监测,有助于早期发现肺癌,改善预后.
Abstract
Objective To investigate the clinical characteristics of 16 patients with connective tissue diseases associated interstitial lung disease(CTD-ILD)complicated with lung cancer,and to improve the cognition of the disease.Methods Clinical data of 16 patients diagnosed as CTD-ILD associated with lung cancer,who were admitted to our center,were retrospectively analyzed,including general conditions,clinical characteristics,auxiliary examinations,pathological classification of lung cancer,TNM type,treatment and clinical outcome.Results Among the 16 CTD-ILD patients with lung cancer,there were 12 males and 4 females.The mean age at diagnosis of CTD-ILD was(64.7±9.2)years,and the mean age at diagnosis of lung cancer was(66.6±8.7)years.Lung occupying space on imaging(62.5%)was the most common initial symptom in lung cancer patients,followed by cough and phlegm(12.5%)and chest pain(12.5%).Of patients with lung cancer,adenocarcinoma(8 cases,50.0%)was the most common pathological type,followed by small cell lung cancer(4 cases,25.0%).The diagnosis time of CTD-ILD was earlier than that of lung cancer in 8 cases(50.0%),with a median time of 36.0(11.3,57.0)months,followed by 7 cases(43.8%)of CTD-ILD diagnosed with lung cancer at the same time.The diagnosis time of lung cancer was earlier than that of CTD-ILD in 1 case(6.3%).The most common TNM stage for lung cancer was stage Ⅳ(9 cases,56.25%).Sixteen patients were followed up from 1 to 64 months,with a median of 8.5(1.5,14.3)months.Eleven patients(68.8%)died,including 8 patients(72.7%)died of infection and 3 patients(27.3%)died of end-stage lung cancer.Conclusion For CTD-ILD patients,close follow-up and regular imaging monitoring are necessary to help early detection of lung cancer and improve prognosis.
关键词
结缔组织疾病/肺疾病,间质性/肺肿瘤/免疫抑制剂Key words
connective tissue diseases/lung diseases,interstitial/lung neoplasms/immunosuppressive agents引用本文复制引用
出版年
2024
NETL
NSTL
万方数据