Adzić Tatjana N, Pesut Dragica P, Nagorni-Obradović Ljudmila M, Stojsić Jelena M, Vasiljević Mladenko D, Bouros Demosthenes
Institute of Lung diseases and Tuberculosis, Clinical Centre of Serbia, Belgrade, Serbia.
Respir Med. 2008 Apr;102(4):620-4. doi: 10.1016/j.rmed.2007.10.022. Epub 2008 Jan 4.
Connective tissue diseases (CTD) might be associated with various malignancies, and one of the most frequent is lung cancer (LC). Despite our understanding of pathogenesis, this association remains still unclear. The aim of the present study is to describe the clinical characteristics of patients with CTD who developed LC.
Of 375 successive patients with CTD followed up to University Hospital between 1995 and 2004, 24 patients were diagnosed with LC: 11 (46%) had systemic sclerosis (SSc), 6 (25%) rheumatoid arthritis (RA), 6 (25%) systemic lupus erythematosus (SLE), and 1 (4%) dermatomyositis. We analyzed LC stage, radiological presentation, histological type, patients' smoking status, method of diagnosis, treatment applied, and disease outcome.
Average duration of CTD was 13.95 (range 0-30) years. Non-small cell lung cancer (NSCLC) was significantly more frequent than small-cell lung cancer (SCLC). Among patients with NSCLC, 21 patients (85%) presented with stage III or IV. With regard to treatment, 13% patients underwent surgery, 25% chemotherapy, 4% patients combined chemo- and radiotherapy and 58% patients had only supportive therapy. The median survival was 5 months (range 1-96 months).
The majority of CTD patients who developed LC were diagnosed at advanced stage and had poor survival. Efforts for early detection of LC in CTD patients' group are warranted.
结缔组织病（CTD）可能与多种恶性肿瘤相关，其中最常见的是肺癌（LC）。尽管我们对其发病机制有所了解，但这种关联仍不明确。本研究的目的是描述发生肺癌的CTD患者的临床特征。
在1995年至2004年间连续随访至大学医院的375例CTD患者中，24例被诊断为肺癌：11例（46%）患有系统性硬化症（SSc），6例（25%）患有类风湿关节炎（RA），6例（25%）患有系统性红斑狼疮（SLE），1例（4%）患有皮肌炎。我们分析了肺癌的分期、影像学表现、组织学类型、患者吸烟状况、诊断方法、应用的治疗以及疾病转归。
CTD的平均病程为13.95（范围0 - 30）年。非小细胞肺癌（NSCLC）比小细胞肺癌（SCLC）明显更常见。在NSCLC患者中，21例（85%）表现为III期或IV期。关于治疗，13%的患者接受了手术，25%接受了化疗，4%的患者接受了化疗和放疗联合治疗，58%的患者仅接受了支持性治疗。中位生存期为5个月（范围1 - 96个月）。
大多数发生肺癌的CTD患者被诊断为晚期且生存期较差。有必要努力在CTD患者群体中早期发现肺癌。
