Pulmonary Department, Hospital Álvaro Cunqueiro, EOXI de Vigo, Vigo, Spain.
NeumoVigoI+i Research Group, Vigo Biomedical Research Institute (IBIV), Vigo, Spain.
Respiration. 2018;95(6):414-421. doi: 10.1159/000487243. Epub 2018 Mar 27.
Lung cancer (LC) and chronic obstructive pulmonary disease (COPD) are associated with increased morbidity and mortality. The differential clinical and functional features among LC patients with or without COPD have not been defined.
The aims of this study were to examine the prevalence and underdiagnosis rate of COPD in LC patients and to compare the clinical and functional features of LC patients with and without COPD.
We designed a multicenter hospital-based study including all LC cases diagnosed from January 2014 to August 2016. We assessed epidemiological, clinical, radiological, functional, and histological variables in all cases.
We recruited 602 patients with LC, most of them men (77.9%), with a median age of 67 ± 15 years. The COPD prevalence among LC patients was 51.5%, with a underdiagnosis rate of 71.6%. The LC+COPD patients were older and the proportion of men was higher compared with the LC-only patients. The LC+COPD patients had more pack-years, more squamous LC, a lower monoxide transfer coefficient (KCO), and higher Charlson index scores than patients with LC only. The median survival of LC-only patients was 37% longer than that of LC+COPD patients (22 vs. 16 months), but this difference was not statistically significant.
Among LC patients, COPD is prevalent and underdiagnosed. Patients with LC+COPD more often have squamous LC, have greater comorbidities, and have a lower KCO. More effort should be made for an early diagnosis of COPD to select patients at higher risk of developing LC.
肺癌（LC）和慢性阻塞性肺疾病（COPD）与发病率和死亡率的增加有关。LC 患者中有无 COPD 的临床和功能特征差异尚未明确。
本研究旨在检查 LC 患者中 COPD 的患病率和漏诊率，并比较有和无 COPD 的 LC 患者的临床和功能特征。
我们设计了一项多中心基于医院的研究，包括 2014 年 1 月至 2016 年 8 月期间诊断的所有 LC 病例。我们评估了所有病例的流行病学、临床、影像学、功能和组织学变量。
我们招募了 602 例 LC 患者，其中大多数为男性（77.9%），中位年龄为 67±15 岁。LC 患者中 COPD 的患病率为 51.5%，漏诊率为 71.6%。LC+COPD 患者比 LC 患者年龄更大，男性比例更高。LC+COPD 患者的吸烟包年数更多，鳞状细胞癌更多，一氧化碳转移系数（KCO）更低，Charlson 指数评分更高。LC 患者的中位生存期比 LC+COPD 患者长 37%（22 个月 vs. 16 个月），但差异无统计学意义。
在 LC 患者中，COPD 很常见且被漏诊。LC+COPD 患者更常患有鳞状细胞癌，合并症更多，KCO 更低。应更加努力进行 COPD 的早期诊断，以选择具有更高发生 LC 风险的患者。
