Department of Pulmonary and Critical Care Medicine, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, No.1 Shuaifuyuan Street, Dongcheng District, Beijing, 100730, China.
Pathological Department of Anesthesiology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, No.1 Shuaifuyuan Street, Dongcheng District, Beijing, 100730, China.
Clin Exp Med. 2023 Oct;23(6):2321-2330. doi: 10.1007/s10238-023-00999-1. Epub 2023 Jan 30.
This study aimed to explore the general characteristics and spectrum of hospitalized Chinese patients suffering from lung cancer with concomitant interstitial lung disease (LC-ILD). Furthermore, we compared their features before and after the period of immunotherapy for lung cancer. A retrospective analysis of the clinical characteristics of hospitalized LC patients with definite pathological diagnoses was performed from 2014 to 2021. ILD was defined after the review of chest CT imaging. There were 13,085 hospitalized LC patients. Among them, 509 patients (3.89%) had 551 cases of ILD. There were variable underlying causes of ILD, including idiopathic interstitial pneumonia (360 patients), LC treatment-associated ILD (134 cases), and connective tissue disease-associated ILD (55 patients). Although most LC-ILD patients were suffering from adenocarcinoma (204/40.1%), SCLC patients were prone to concomitant ILD (10.8% of all SCLC cases), followed by SCC (9.6% of all SCC cases). All but 10 LC-ILD patients received anti-LC treatment; however, only 39 (10.8%) LC-IIP patients received anti-ILD treatment. There were more LC-ILD patients in the 2018-2021 group than in the 2014-2017 group (5.16% vs. 2.03%, p < 0.001). The underlying causes of ILD were significantly different between the 2018-2021 group and the 2014-2017 group (p < 0.001). After adjusting for the number of hospitalized patients having the same LC pathological pattern, SCLC was determined to be the most likely to be concomitant with ILD, followed by SCC. Most LC-ILD patients were scheduled for anti-LC therapy; however, treatments for concomitant IIP were usually ignored. LC treatment-associated ILD should receive more attention than before.
这项研究旨在探讨患有肺癌合并间质性肺病（LC-ILD）的住院中国患者的一般特征和谱。此外，我们还比较了他们在肺癌免疫治疗前后的特征。对 2014 年至 2021 年期间明确病理诊断的住院 LC 患者的临床特征进行回顾性分析。ILD 是在胸部 CT 影像学复查后定义的。共有 13085 例住院 LC 患者，其中 509 例（3.89%）有 551 例ILD。ILD 的潜在病因各不相同，包括特发性间质性肺炎（360 例）、LC 治疗相关 ILD（134 例）和结缔组织病相关 ILD（55 例）。尽管大多数 LC-ILD 患者患有腺癌（204/40.1%），但小细胞肺癌患者更容易合并 ILD（所有小细胞肺癌病例的 10.8%），其次是鳞状细胞癌（所有鳞状细胞癌病例的 9.6%）。除 10 例 LC-ILD 患者外，所有患者均接受了 LC 治疗；然而，只有 39 例（10.8%）LC-特发性间质性肺炎患者接受了抗 ILD 治疗。2018-2021 年组的 LC-ILD 患者多于 2014-2017 年组（5.16%比 2.03%，p<0.001）。2018-2021 年组和 2014-2017 年组间 ILD 的潜在病因有显著差异（p<0.001）。调整具有相同 LC 病理模式的住院患者人数后，小细胞肺癌被确定为最有可能合并 ILD，其次是鳞状细胞癌。大多数 LC-ILD 患者被安排接受 LC 治疗；然而，通常会忽略对合并 IIP 的治疗。LC 治疗相关的 ILD 应该比以前受到更多的关注。
