Asthma and COPD Program, Division of Pulmonary and Critical Care Medicine, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA.
Curr Opin Pulm Med. 2012 Mar;18(2):131-7. doi: 10.1097/MCP.0b013e32834f2080.
An associative and mechanistic link between chronic obstructive pulmonary disease (COPD) and lung cancer has long been suspected. This review describes the current understanding of the incidence, mechanism of association, treatment options, and outcome for lung cancer with COPD.
COPD patients have an increased risk of lung cancer that is independent of smoking. New evidence suggests that there is an inverse relationship between the severity of airflow obstruction and the risk of lung cancer. Chronic inflammation associated with COPD may play a role in the development of lung cancer, and targeting airway inflammation with inhaled corticosteroids has been suggested as a possible preventive strategy. Although surgical lobectomy remains the standard of care for early stage lung cancer, less invasive approaches such as sublobar resection, stereotactic body radiation therapy, and radiofrequency ablation are promising techniques for patients with limited pulmonary reserve.
Progress is being made in identifying mechanistic links between COPD and lung cancer, which may lead to novel therapeutic strategies for both disorders. Patients with COPD are likely to benefit from less-invasive surgical and nonsurgical treatment strategies for lung cancer, but further study is needed to determine the safety and efficacy of these procedures.
慢性阻塞性肺疾病（COPD）和肺癌之间存在关联和机制联系早已受到怀疑。本综述描述了目前对 COPD 合并肺癌的发病率、关联机制、治疗选择和转归的理解。
COPD 患者患肺癌的风险增加，且与吸烟无关。新证据表明，气流阻塞的严重程度与肺癌的风险呈反比关系。与 COPD 相关的慢性炎症可能在肺癌的发展中起作用，并且用吸入皮质类固醇靶向气道炎症被认为是一种可能的预防策略。虽然肺叶切除术仍然是早期肺癌的标准治疗方法，但对于肺储备有限的患者，亚肺叶切除术、立体定向体部放射治疗和射频消融等微创方法是很有前途的技术。
在确定 COPD 和肺癌之间的机制联系方面正在取得进展，这可能为这两种疾病带来新的治疗策略。COPD 患者可能受益于针对肺癌的微创和非手术治疗策略，但需要进一步研究来确定这些手术的安全性和疗效。
