对寻常型间质性肺炎患者手术切除的肺癌的临床病理研究

A clinicopathological study of surgically resected lung cancer in patients with usual interstitial pneumonia.

作者信息

Watanabe Yasutaka, Kawabata Yoshinori, Koyama Nobuyuki, Ikeya Tomohiko, Hoshi Eishin, Takayanagi Noboru, Koyama Shinichiro

机构信息

Division of Diagnostic Pathology, Saitama Prefectural Cardiovascular and Respiratory Center, 1696 Itai, Kumagaya City, Saitama, 360-0105, Japan; Division of Pulmonary Medicine, Clinical Department of Internal Medicine, Jichi Medical University, Saitama Medical Center, 1-847, Amanuma-cho, Omiya City, Saitama, 330-8503, Japan; Department of Clinical Oncology, Tokyo Medical University Hachioji Medical Center, 1163 Tatemachi, Hachioji City, Tokyo, 193-0998, Japan.

Division of Diagnostic Pathology, Saitama Prefectural Cardiovascular and Respiratory Center, 1696 Itai, Kumagaya City, Saitama, 360-0105, Japan.

出版信息

Respir Med. 2017 Aug;129:158-163. doi: 10.1016/j.rmed.2017.06.015. Epub 2017 Jun 23.

DOI:10.1016/j.rmed.2017.06.015

PMID:28732824

Abstract

BACKGROUND

The clinicopathological characteristics of lung cancer with concomitant usual interstitial pneumonia (UIP) are insufficiently understood. This study aimed to elucidate a characteristic pathological feature of lung cancer that develops in patients with UIP, with a focus on the location of its onset.

METHODS

We reviewed surgically obtained specimens, including 547 tumors from 526 patients who underwent lobectomy for lung cancer. Surveyed patients were classified into three groups: patients with UIP (UIP group), patients with lung pathology other than UIP (non-UIP group), and patients without any associated lung pathology (normal group). The histology as well as the lobe and location of the onset of lung cancer were compared among these groups. The peripheral location was subdivided into subpleural, inner and tumor involved centrally secondary to extension.

RESULTS

The UIP group comprised 82 patients (male, 71 [87%]; mean age, 71 years; smoking rate, 94%), the non-UIP group comprised 334 patients (male, 267 [80%]; mean age, 69 years; smoking rate, 81%), and the normal group comprised 110 patients (male, 33 [30%]; mean age, 63; smoking rate, 29%). No statistical differences were noted in sex, mean age, or smoking index between the UIP and non-UIP groups. Compared with the non-UIP group, the frequency of squamous cell carcinoma (63% vs. 32%), lower lobe origin (76% vs. 32%), and subpleural location (24% vs. 5%) were significantly higher in the UIP group.

CONCLUSIONS

Lung cancers in patients with UIP show a predilection for the subpleural region, where UIP is also thought to originate.

摘要

背景

肺癌合并寻常型间质性肺炎（UIP）的临床病理特征尚未得到充分了解。本研究旨在阐明UIP患者发生的肺癌的特征性病理特征，重点关注其发病部位。

方法

我们回顾了手术获取的标本，包括526例因肺癌接受肺叶切除术患者的547个肿瘤。将接受调查的患者分为三组：UIP患者（UIP组）、有UIP以外肺部病理改变的患者（非UIP组）和无任何相关肺部病理改变的患者（正常组）。比较这些组之间肺癌的组织学以及肺叶和发病部位。外周部位细分为胸膜下、内部以及因肿瘤扩展而累及中央的部位。

结果

UIP组包括82例患者（男性71例[87%]；平均年龄71岁；吸烟率94%），非UIP组包括334例患者（男性267例[80%]；平均年龄69岁；吸烟率81%），正常组包括110例患者（男性33例[30%]；平均年龄63岁；吸烟率29%）。UIP组和非UIP组在性别、平均年龄或吸烟指数方面无统计学差异。与非UIP组相比，UIP组鳞状细胞癌的发生率（63%对32%）、下叶起源（76%对32%）和胸膜下部位（24%对5%）显著更高。