Koo Hyun Jung, Do Kyung-Hyun, Lee Jung Bok, Alblushi Sania, Lee Sang Min
Department of Radiology and Research Institute of Radiology, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea.
Clinical Epidemiology and Biostatistics, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea.
PLoS One. 2016 Sep 12;11(9):e0161437. doi: 10.1371/journal.pone.0161437. eCollection 2016.
Patients with combined pulmonary fibrosis and emphysema (CPFE) have been suggested to have an increased risk of lung cancer. We conducted a systematic review of all published data and performed a meta-analysis to define the characteristics of lung cancer that develops in CPFE.
We searched Pubmed, Embase, and Cochrane to find original articles about lung cancer and CPFE published prior to September 2015. All titles/abstracts were reviewed by two radiologists to identify articles that used predefined selection criteria. Summary estimates were generated using a random-effect model and odds ratios (ORs) to develop squamous cell carcinoma (SqCC) were calculated. Kaplan-Meier survival curves were obtained for the survival of patients with CPFE and non-CPFE.
Nine original articles that assessed 620 patients were included in this review. In the pooled data, patients were older age (70.4 years), almost all were heavy smokers (53.5 pack years), and males were predominant (92.6%). SqCC was the most common type (42.3%), followed by adenocarcinoma (34.4%). Compared with lung cancer population with an otherwise normal lung, the OR to develop SqCC in CPFE was 9.06 (95% CI, 6.08-13.5). The ORs in CPFE compared with lung cancers that developed in lungs with fibrosis or emphysema were also higher. The median survival for CPFE patients with lung cancer (19.5 months) was significantly shorter than in non-CPFE (53.1 months).
Lung cancer in CPFE, most commonly SqCC, presents in elderly heavy smokers with a male predominance. The median survival for CPFE patients with lung cancer is 19.5 months.
有研究表明，合并肺纤维化和肺气肿（CPFE）的患者患肺癌的风险增加。我们对所有已发表的数据进行了系统评价，并进行了荟萃分析，以确定CPFE患者所患肺癌的特征。
我们检索了PubMed、Embase和Cochrane数据库，以查找2015年9月之前发表的有关肺癌和CPFE的原始文章。两名放射科医生对所有标题/摘要进行了审查，以确定符合预定义选择标准的文章。使用随机效应模型生成汇总估计值，并计算发生鳞状细胞癌（SqCC）的比值比（OR）。获得了CPFE患者和非CPFE患者的Kaplan-Meier生存曲线。
本评价纳入了9篇评估620例患者的原始文章。在汇总数据中，患者年龄较大（70.4岁），几乎所有人都是重度吸烟者（53.5包年），男性占主导（92.6%）。SqCC是最常见的类型（42.3%），其次是腺癌（34.4%）。与肺部正常的肺癌患者相比，CPFE患者发生SqCC的OR为9.06（95%CI，6.08-13.5）。与在有纤维化或肺气肿的肺部发生的肺癌相比，CPFE患者的OR也更高。CPFE肺癌患者的中位生存期（19.5个月）明显短于非CPFE患者（53.1个月）。
CPFE患者的肺癌，最常见的是SqCC，多见于老年重度吸烟男性。CPFE肺癌患者的中位生存期为19.5个月。
