天津医药

天津医药 ›› 2024, Vol. 52 ›› Issue (7): 687-690.doi: 10.11958/20231785

• 专题研究·结缔组织病-间质性肺病/肺动脉高压（主编 魏蔚） • 上一篇    下一篇

结缔组织病相关间质性肺病合并肺癌16例临床分析

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,∆()   

  1. 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科技处
  • 收稿日期:2023-11-17 修回日期:2024-01-14 出版日期:2024-07-15 发布日期:2024-07-11
  • 通讯作者: ∆E-mail：wyhxxtt@163.com
  • 作者简介:张国华（1983），女，副主任医师，主要从事自身免疫性疾病与肿瘤的相关研究。E-mail：zhangguohuamao@163.com

Clinical analysis of 16 cases of connective tissue disease-associated interstitial lung disease complicated with lung cancer

ZHANG Guohua1(), ZHANG Lingling1, GAO Lan1, LUO Junli1, SHEN Yawen1, LIU Lei2, WANG Yuhua1,∆()   

  1. 1 Department of Rheumatology, 2 Department of Science and Technology, Beijing Shijitan Hospital, Capital Medical University, Beijing 100038, China
  • Received:2023-11-17 Revised:2024-01-14 Published:2024-07-15 Online:2024-07-11
  • Contact: ∆E-mail: wyhxxtt@163.com

RichHTML

0

PDF (PC)

69

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。

关键词: 结缔组织疾病, 肺疾病, 间质性, 肺肿瘤, 免疫抑制剂

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.

Key words: connective tissue diseases, lung diseases, interstitial, lung neoplasms, immunosuppressive agents

中图分类号: