Nagano Masaaki, Cong Yue, Nakao Keita, Kawashima Mitsuaki, Konoeda Chihiro, Sato Masaaki
Department of Thoracic Surgery, The University of Tokyo Graduate School of Medicine, 7-3-1 Hongo, Bunkyo-Ku, Tokyo, 113-8655, Japan.
Surg Today. 2025 Apr;55(4):518-525. doi: 10.1007/s00595-024-02917-8. Epub 2024 Sep 25.
While patients with autoimmune diseases (ADs) are at high risk for developing specific malignancies, including lung cancer, ADs may protect against the development of cancer through increased immune cell activity in tumors. This study aimed to investigate whether the presence of ADs affects surgical outcomes and survival after surgery for lung cancer.
The medical records of 1236 patients who underwent surgery for non-small cell lung cancer between 2007 and 2018 were retrospectively reviewed. Perioperative and long-term outcomes were compared between patients with and without ADs using propensity score matching.
Among the included patients, 115 with ADs and 1121 without ADs underwent surgery. Using 1-to-1 propensity score matching, 114 pairs were selected. Although there were no significant differences in the perioperative outcomes of the two groups, the overall and relapse-free survival rates were significantly lower in the group with ADs than in the group without ADs.
Surgery for lung cancer can be performed without increasing the complications in patients with ADs. However, the long-term outcomes were significantly worse in patients with ADs than in those without ADs, suggesting that close follow-up for lung cancer and careful whole-body examination might be needed for patients with ADs.
自身免疫性疾病（AD）患者患特定恶性肿瘤（包括肺癌）的风险较高，而AD可能通过增加肿瘤中免疫细胞活性来预防癌症发生。本研究旨在调查AD的存在是否会影响肺癌手术的结果及术后生存率。
回顾性分析2007年至2018年间1236例行非小细胞肺癌手术患者的病历。采用倾向评分匹配法比较有和没有AD的患者的围手术期和长期结果。
纳入的患者中，115例有AD，1121例无AD接受了手术。采用1:1倾向评分匹配，选择了114对。虽然两组围手术期结果无显著差异，但有AD的组的总生存率和无复发生存率显著低于无AD的组。
AD患者进行肺癌手术不会增加并发症。然而，有AD的患者的长期结果明显比无AD的患者差，这表明对AD患者可能需要密切的肺癌随访和仔细的全身检查。
