Daniels Craig E, Jett James R
Division of Pulmonary and Critical Care Medicine, Mayo Clinic, Rochester, Minnesota 55905, USA.
Curr Opin Pulm Med. 2005 Sep;11(5):431-7. doi: 10.1097/01.mcp.0000170521.71497.ba.
This review examines the evidence for the causality and pathogenesis of lung cancer associated with interstitial lung disease.
Although cigarette smoking is the leading cause of lung cancer, several other conditions either predispose to lung cancer or increase the risk of lung cancer in smokers. The evidence supports an increased risk of lung cancer due to specific fibrotic and inflammatory lung diseases (termed interstitial lung diseases), including idiopathic pulmonary fibrosis, systemic sclerosis, and certain pneumoconioses. The potential pathogenetic mechanisms indicate that recurrent injury and inflammation result in genetic alterations that predispose to lung cancer.
Idiopathic pulmonary fibrosis, systemic sclerosis, and certain pneumoconioses are associated with an independent increased risk of lung cancer; however, a unifying pathogenetic mechanism to explain the causality of this association has not been described. In addition, the inconsistently reported lung cancer frequencies call attention to the need for prospective studies of good quality.
本综述探讨与间质性肺疾病相关的肺癌的因果关系及发病机制的证据。
尽管吸烟是肺癌的主要病因,但其他几种情况要么易患肺癌,要么增加吸烟者患肺癌的风险。有证据支持特定的纤维化和炎症性肺部疾病(称为间质性肺疾病)会增加患肺癌的风险,这些疾病包括特发性肺纤维化、系统性硬化症和某些尘肺。潜在的发病机制表明,反复损伤和炎症会导致基因改变,从而易患肺癌。
特发性肺纤维化、系统性硬化症和某些尘肺与肺癌独立发病风险增加相关;然而,尚未描述一种统一的发病机制来解释这种关联的因果关系。此外,肺癌发病率报道不一致,这凸显了高质量前瞻性研究的必要性。