Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Seoul National University Hospital, 101 Daehak-ro, Jongno-gu, Seoul, 03080, Republic of Korea.
Sci Rep. 2020 Oct 26;10(1):18260. doi: 10.1038/s41598-020-75276-2.
No studies on idiopathic pulmonary fibrosis (IPF) have investigated the prognostic impact of extrapulmonary cancers in patients with IPF. We aimed to determine the prognostic impact of malignancies in patients with IPF. We retrospectively reviewed the medical records of patients diagnosed with IPF between 2001 and 2015. Patients were divided into three groups: IPF without cancer (n = 440), IPF with lung cancer (n = 69), and IPF with extrapulmonary cancer (n = 70). Of the 579 patients with IPF, 139 (24%) had cancer; the three most common types were lung (11.9%), gastric (2.4%), and colorectal (1.9%). Survival was significantly worse in patients with lung cancer than in those without cancer (hazard ratio [HR] = 1.83, 95% confidence interval [CI], 1.35-2.48) or those with extrapulmonary cancer (HR = 1.70, 95% CI, 1.14-2.54). The rate of hospitalisation for cancer-related complications was significantly higher in IPF patients with lung cancer than in those with extrapulmonary cancer. The annual rates of decline in percent predicted forced vital capacity and diffusion capacity for carbon monoxide did not differ among the groups. Physicians should pay attention to the development and progression of cancer and its prognostic impact in patients with IPF.
尚无研究调查特发性肺纤维化 (IPF) 患者中肺外癌症对预后的影响。我们旨在确定 IPF 患者中恶性肿瘤的预后影响。我们回顾性地审查了 2001 年至 2015 年间诊断为 IPF 的患者的病历。患者分为三组：无癌症的 IPF（n=440）、IPF 合并肺癌（n=69）和 IPF 合并肺外癌症（n=70）。在 579 例 IPF 患者中，有 139 例（24%）患有癌症；最常见的三种类型是肺癌（11.9%）、胃癌（2.4%）和结直肠癌（1.9%）。肺癌患者的生存率明显低于无癌症患者（风险比 [HR] = 1.83，95%置信区间 [CI]，1.35-2.48）或肺外癌症患者（HR = 1.70，95% CI，1.14-2.54）。肺癌合并 IPF 患者因癌症相关并发症住院的比率明显高于肺外癌症患者。三组患者预测用力肺活量和一氧化碳弥散量的年下降率无差异。医生应注意 IPF 患者癌症的发生和进展及其对预后的影响。
