Gibiot Quentin, Monnet Isabelle, Levy Pierre, Brun Anne-Laure, Antoine Martine, Chouaïd Christos, Cadranel Jacques, Naccache Jean-Marc
Service de Pneumologie, Centre Hospitalier Intercommunal de Créteil, 94000 Créteil, France.
Faculté de Médecine, Université Paris-Est Créteil, 94000 Créteil, France.
J Clin Med. 2020 Mar 5;9(3):700. doi: 10.3390/jcm9030700.
Interstitial lung disease (ILD) seems to be associated with an increased risk of lung cancer (LC) and to have a poorer prognosis than LC without ILD. The frequency of ILD in an LC cohort and its prognosis implication need to be better elucidated. This retrospective, observational, cohort study evaluated the frequency of ILD among LC patients (LC-ILD) diagnosed over a 2-year period. LC-ILD patients' characteristics were compared to those with LC without ILD (LC-noILD). Lastly, we conducted a case-control study within this cohort, matching three LC-noILDs to each LC-ILD patient, to evaluate the ILD impact on LC patients' prognoses. Among 906 LC patients, 49 (5.4%) also had ILD. Comparing LC-ILD to LC-noILD patients, respectively, more were men (85.7% vs. 66.2%; = 0.02); adenocarcinomas were less frequent (47.1% vs. 58.7%, = 0.08); median [range] and overall survival was shorter: (9 [range: 0.1-39.4] vs. 17.5 [range: 0.8-50.4] months; = 0.01). Multivariate analysis (hazard ratio [95% confidence interval]) retained two factors independently associated with LC risk of death: ILD (1.79 [1.22-2.62]; = 0.003) and standard-of-care management (0.49 [0.33-0.72]; < 0.001). Approximately 5% of patients with a new LC diagnosis had associated ILD. ILD was a major prognosis factor for LC and should be taken into consideration for LC management. Further studies are needed to determine the best therapeutic strategy for the LC-ILD population.
间质性肺疾病（ILD）似乎与肺癌（LC）风险增加相关，且与无ILD的LC相比预后更差。LC队列中ILD的发生率及其对预后的影响需要进一步阐明。这项回顾性、观察性队列研究评估了2年期间诊断出的LC患者（LC-ILD）中ILD的发生率。将LC-ILD患者的特征与无ILD的LC患者（LC-noILD）进行比较。最后，我们在该队列中进行了一项病例对照研究，为每位LC-ILD患者匹配3名LC-noILD患者，以评估ILD对LC患者预后的影响。在906例LC患者中，49例（5.4%）同时患有ILD。将LC-ILD患者与LC-noILD患者相比，男性更多（85.7%对66.2%；P = 0.02）；腺癌发生率更低（47.1%对58.7%，P = 0.08）；中位[范围]总生存期更短：（9[范围：0.1 - 39.4]对17.5[范围：0.8 - 50.4]个月；P = 0.01）。多因素分析（风险比[95%置信区间]）保留了两个与LC死亡风险独立相关的因素：ILD（1.79[1.22 - 2.62]；P = 0.003）和标准治疗管理（0.49[0.33 - 0.72]；P < 0.001）。新诊断为LC的患者中约5%伴有ILD。ILD是LC的主要预后因素，在LC管理中应予以考虑。需要进一步研究以确定LC-ILD人群的最佳治疗策略。
