Department of Pulmonary and Critical Care Medicine, Beijing Institute of Respiratory Medicine, Beijing Chao-Yang Hospital, Capital Medical University, Beijing, China.
Department of Radiology, Beijing Chao-Yang Hospital, Capital Medical University, Beijing, China.
Thorac Cancer. 2023 Jul;14(19):1874-1882. doi: 10.1111/1759-7714.14935. Epub 2023 May 26.
Along with the improvement of lung cancer screening implementation, the identification of interstitial lung abnormality (ILA) is increasing. Currently, there is a limited description of the oncogenic status and ILA subtypes among newly diagnosed non-small cell lung cancer (NSCLC) patients with ILA in the Chinese population. This study aimed to investigate the prevalence, characteristics, oncogenic status and factors associated with overall survival (OS) among NSCLC patients with ILA.
A total of 765 newly diagnosed NSCLC cases at our hospital were reviewed and ILA was diagnosed according to the criteria of the Fleischner Society. The characteristics, clinical pathological features and OS of NSCLC patients with ILA were retrospectively analyzed.
Of the 765 patients included in the study, 101 (13.2%) cases experienced ILA at the time of NSCLC diagnosis. Multivariate analysis revealed that ILA was more likely to be detected in NSCLC patients who were age ≥60 (OR 2.404, p = 0.001), male gender (OR 2.476, p = 0.004), and EGFR wild-type (OR 2.035, p = 0.007). Additionally, according to the multivariate Cox model, the presence of ILA in NSCLC patients was significantly associated with a shorter OS period than those without ILA (751 days vs. 445 days, HR 0.6, p = 0.001). Following analysis, it was determined that OS in patients with usual interstitial pneumonia (UIP) was shorter than in those without UIP (HR 1.82, p = 0.037).
ILA is a common comorbidity among newly diagnosed NSCLC patients. We found that patients with EGFR wild-type NSCLC were more likely to develop ILA. The presence of ILA, especially UIP, was significantly associated with poor NSCLC prognosis.
随着肺癌筛查实施的改善，间质性肺异常（ILA）的检出率不断增加。目前，在中国人群中，新诊断的非小细胞肺癌（NSCLC）患者伴有 ILA 的致癌状态和 ILA 亚型描述有限。本研究旨在探讨 NSCLC 伴有 ILA 患者的患病率、特征、致癌状态和与总生存（OS）相关的因素。
回顾性分析我院收治的 765 例新诊断的 NSCLC 患者，根据 Fleischner 学会的标准诊断 ILA。分析 NSCLC 伴有 ILA 患者的特征、临床病理特征和 OS。
在纳入研究的 765 例患者中，101 例（13.2%）在诊断 NSCLC 时伴有 ILA。多因素分析显示，年龄≥60 岁（OR 2.404，p=0.001）、男性（OR 2.476，p=0.004）和 EGFR 野生型（OR 2.035，p=0.007）的 NSCLC 患者更有可能检出 ILA。此外，根据多因素 Cox 模型，与无 ILA 的 NSCLC 患者相比，伴有 ILA 的 NSCLC 患者 OS 更短（751 天比 445 天，HR 0.6，p=0.001）。进一步分析发现，伴有普通型间质性肺炎（UIP）的患者 OS 短于无 UIP 的患者（HR 1.82，p=0.037）。
ILA 是新诊断的 NSCLC 患者常见的合并症。我们发现 EGFR 野生型 NSCLC 患者更易发生 ILA。ILA 的存在，特别是 UIP，与 NSCLC 不良预后显著相关。
