Department of Respiratory Medicine, University Hospital of Patras, Patras, Greece.
Respiratory Disease Unit, Department of Cardiac, Thoracic, Vascular Sciences and Public Health, University of Padova, Padova, Italy.
Respirology. 2023 Jan;28(1):56-65. doi: 10.1111/resp.14363. Epub 2022 Sep 18.
There remains a paucity of large databases for patients with idiopathic pulmonary fibrosis (IPF) and lung cancer. We aimed to create a European registry.
This was a multicentre, retrospective study across seven European countries between 1 January 2010 and 18 May 2021.
We identified 324 patients with lung cancer among 3178 patients with IPF (prevalence = 10.2%). By the end of the 10 year-period following IPF diagnosis, 26.6% of alive patients with IPF had been diagnosed with lung cancer. Patients with IPF and lung cancer experienced increased risk of all-cause mortality than IPF patients without lung cancer (HR: 1.51, [95% CI: 1.22-1.86], p < 0.0001). All-cause mortality was significantly lower for patients with IPF and lung cancer with a monocyte count of either <0.60 or 0.60-<0.95 K/μl than patients with monocyte count ≥0.95 K/μl (HR [<0.60 vs. ≥0.95 K/μl]: 0.35, [95% CI: 0.17-0.72], HR [0.60-<0.95 vs. ≥0.95 K/μl]: 0.42, [95% CI: 0.21-0.82], p = 0.003). Patients with IPF and lung cancer that received antifibrotics presented with decreased all cause-mortality compared to those who did not receive antifibrotics (HR: 0.61, [95% CI: 0.42-0.87], p = 0.006). In the adjusted model, a significantly lower proportion of surgically treated patients with IPF and otherwise technically operable lung cancer experienced all-cause mortality compared to non-surgically treated patients (HR: 0.30 [95% CI: 0.11-0.86], p = 0.02).
Lung cancer exerts a dramatic impact on patients with IPF. A consensus statement for the management of patients with IPF and lung cancer is sorely needed.
特发性肺纤维化（IPF）和肺癌患者的大型数据库仍然匮乏。我们旨在创建一个欧洲注册中心。
这是一项多中心、回顾性研究，在 2010 年 1 月 1 日至 2021 年 5 月 18 日期间，在七个欧洲国家进行。
在 3178 例 IPF 患者中，我们共发现 324 例肺癌患者（患病率为 10.2%）。在 IPF 诊断后的 10 年内，26.6%的存活 IPF 患者被诊断患有肺癌。与未患有肺癌的 IPF 患者相比，患有 IPF 和肺癌的患者全因死亡率的风险增加（HR：1.51，95%CI：1.22-1.86，p<0.0001）。IPF 合并肺癌患者的全因死亡率明显低于单核细胞计数≥0.95 K/μl 的患者（单核细胞计数<0.60 与≥0.95 K/μl：0.35，95%CI：0.17-0.72，单核细胞计数 0.60-<0.95 与≥0.95 K/μl：0.42，95%CI：0.21-0.82，p=0.003）。与未接受抗纤维化治疗的患者相比，接受抗纤维化治疗的 IPF 合并肺癌患者的全因死亡率降低（HR：0.61，95%CI：0.42-0.87，p=0.006）。在调整后的模型中，与未接受手术治疗的患者相比，接受手术治疗的 IPF 合并有可手术治疗的肺癌患者的全因死亡率明显更低（HR：0.30，95%CI：0.11-0.86，p=0.02）。
肺癌对 IPF 患者产生了巨大影响。非常需要为 IPF 和肺癌患者的管理制定共识声明。
