Qin Jianwen, Li Guangsheng, Zhou Jingmin
Department of Respiratory and Critical Care Medicine, Tianjin Chest Hospital, Tianjin, People's Republic of China.
Int J Chron Obstruct Pulmon Dis. 2016 Jul 4;11:1515-20. doi: 10.2147/COPD.S104670. eCollection 2016.
To investigate the clinical features, diagnosis, and treatment status of elderly patients with chronic obstructive pulmonary disease (COPD) complicated with lung cancer.
This was a retrospective study of 206 patients aged >60 years with COPD and newly diagnosed lung cancer at the Tianjin Chest Hospital Respiratory Centre between September 2008 and September 2013. Lung function, radiology, and clinical data were retrieved.
Among all patients, 57% (117/206) were hospitalized due to acute COPD aggravation, 47% (96/206) had COPD grade III or IV, 95% (195/206), showed diffusion dysfunction in pulmonary function examination, 90% (185/206) had a history of smoking, and 26% (54/206) were treated with inhaled corticosteroids for COPD treatment. Ninety-eight patients suffered from squamous carcinoma, 73 from adenocarcinoma, and 35 from small-cell carcinoma. Clinical staging was I in 36 patients, II in 47 patients, III in 78 patients, and IV in 45 patients. Initial treatments were surgery in 59 patients, chemotherapy in 30 patients, and no treatment in 117 patients. Multivariate analysis showed that age (P<0.001), COPD grades (P=0.01), clinical staging (P<0.001), and pulmonary diffusion function (P=0.007) were independent factors associated with patients with COPD being given treatments for lung cancer.
Younger patients with lower COPD grades, earlier lung cancer stage, and better pulmonary diffusion function are more likely to receive treatments.
探讨老年慢性阻塞性肺疾病（COPD）合并肺癌患者的临床特征、诊断及治疗状况。
这是一项回顾性研究，对2008年9月至2013年9月期间在天津市胸科医院呼吸中心新诊断为肺癌的206例年龄>60岁的COPD患者进行研究。收集肺功能、放射学及临床资料。
所有患者中，57%（117/206）因COPD急性加重住院，47%（96/206）为COPDⅢ或Ⅳ级，95%（195/206）肺功能检查显示弥散功能障碍，90%（185/206）有吸烟史，26%（54/206）接受吸入性糖皮质激素治疗COPD。98例为鳞状细胞癌，73例为腺癌，35例为小细胞癌。临床分期为Ⅰ期36例，Ⅱ期47例，Ⅲ期78例，Ⅳ期45例。初始治疗59例为手术，30例为化疗，117例未治疗。多因素分析显示，年龄（P<0.001）、COPD分级（P=0.01）、临床分期（P<0.001）及肺弥散功能（P=0.007）是与COPD患者接受肺癌治疗相关的独立因素。
COPD分级较低、肺癌分期较早且肺弥散功能较好的年轻患者更有可能接受治疗。
