Ohtsuka Y, Ukita H, Masaki Y, Doi I, Munakata M, Kawakami Y, Homma Y
First Department of Medicine, School of Medicine, Hokkaido University, Sapporo, Japan.
Nihon Kyobu Shikkan Gakkai Zasshi. 1991 May;29(5):560-5.
The incidence of lung cancer in 45 patients (37 males and 8 females), who were originally diagnosed as having idiopathic interstitial pneumonia (IIP), was studied prospectively by following them 4 to 10 years. As controls, sex-, age-, and smoking history matched patients with chronic obstructive lung disease (COLD) were also surveyed for the same follow up period. In addition, the differences in clinical findings between those with and without lung cancer were examined. Eight out of 45 patients with IIP (18%) developed lung cancer (adenocarcinoma; 4, small cell carcinoma; 3, squamous cell carcinoma; 2, including one double cancer). All lung cancer patients were male smokers. Looking only at males, 8 out of 37 patients with IIP (21.6%) developed lung cancer. This incidence was significantly higher than that of the male COLD group (2.2%, less than 0.01). In clinical findings, IIP patients with lung cancer had the characteristics of the chronic type of IIP (lack of volume loss on chest radiographic milder dyspnea, not on steroid treatment) when compared with those who did not develop lung cancer.
对45例最初诊断为特发性间质性肺炎(IIP)的患者(37例男性和8例女性)进行了4至10年的前瞻性研究,以观察肺癌的发病率。作为对照,在相同的随访期内,对性别、年龄和吸烟史相匹配的慢性阻塞性肺疾病(COLD)患者也进行了调查。此外,还检查了患肺癌和未患肺癌患者之间的临床发现差异。45例IIP患者中有8例(18%)发生了肺癌(腺癌4例、小细胞癌3例、鳞状细胞癌2例,包括1例双癌)。所有肺癌患者均为男性吸烟者。仅看男性,37例IIP患者中有8例(21.6%)发生了肺癌。这一发病率显著高于男性COLD组(2.2%,P<0.01)。在临床发现方面,与未发生肺癌的IIP患者相比,发生肺癌的IIP患者具有慢性IIP类型的特征(胸部X线片上无肺容积减少、呼吸困难较轻、未接受类固醇治疗)。