Xu Rui, Yin Lijie, Qiang Guangliang, Fu Liping
Department of Nuclear Medicine, China-Japan Friendship Hospital, Beijing, China.
Department of Thoracic Surgery, Peking University Third Hospital, Beijing, China.
J Thorac Dis. 2025 Mar 31;17(3):1541-1551. doi: 10.21037/jtd-24-1512. Epub 2025 Mar 10.
Compared to general population, patients with interstitial lung disease (ILD) shows an increased risk of lung cancer (LC), and higher LC complications. Hence, this study aims to analyze the factors related to the postoperative complications and mortality of patients with malignant lung tumor-and ILD after surgical resection.
This study analyzed the clinical information, surgical conditions, preoperative computed tomography (CT) and positron emission tomography (PET) examination data, as well as postoperative follow-up data of 60 non-small cell LC patients and 60 non-small cell LC patients with interstitial lung disease (LC-ILD). In this study, 120 patients with non-small cell LC were retrospectively reviewed, of which 60 were assigned to LC group and 60 to LC-ILD group. Cohorts were evaluated for differences in clinical data, surgical conditions, preoperative CT/PET examination data, and postoperative follow-up data.
The postoperative complications in the LC-ILD group were slightly higher than those in the LC group (P<0.001), and the prognosis of LC patients with ILD was significantly worse than that of those without ILD (P=0.048). The standardized uptake value ratio (SUVR) of noncancerous interstitial pneumonia (IP) area in patients with postoperative complications was higher than that of patients without complications (P=0.005), and it was the risk factor for postoperative complications in LC-ILD group [hazard ratio (HR) 3.384 (1.023-25.441); P=0.02]. Until the end of follow-up, the CT scores of non-survivors were higher than those of survivors (9.30±3.56 . 5.52±2.26; P=0.001). Age [HR 3.919 (1.094-7.789); P=0.04], the CT score [HR 2.352 (1.028-4.033); P=0.007], and smoking history [HR 0.354 (0.096-0.643); P=0.03] were the risk factors for mortality.
The postoperative complications and mortality of LC-ILD significantly increase. Higher SUVR of noncancerous IP area usually indicates an increase of postoperative complications. Higher CT score and smoking history suggest a poor prognosis. A follow-up longitudinal study is needed to validate the findings.
与普通人群相比，间质性肺疾病（ILD）患者患肺癌（LC）的风险增加，且肺癌并发症更高。因此，本研究旨在分析恶性肺肿瘤合并ILD患者手术切除术后并发症和死亡率的相关因素。
本研究分析了60例非小细胞肺癌患者和60例合并间质性肺疾病的非小细胞肺癌患者（LC-ILD）的临床信息、手术情况、术前计算机断层扫描（CT）和正电子发射断层扫描（PET）检查数据以及术后随访数据。本研究对120例非小细胞肺癌患者进行了回顾性分析，其中60例被分配到肺癌组，60例被分配到LC-ILD组。对两组患者的临床数据、手术情况、术前CT/PET检查数据和术后随访数据的差异进行了评估。
LC-ILD组术后并发症略高于肺癌组（P<0.001），合并ILD的肺癌患者预后明显差于未合并ILD的患者（P=0.048）。术后发生并发症患者的非癌性间质性肺炎（IP）区域的标准化摄取值比（SUVR）高于未发生并发症的患者（P=0.005），且是LC-ILD组术后并发症的危险因素[风险比（HR）3.384（1.023 - 25.441）；P=0.02]。至随访结束时，非存活者的CT评分高于存活者（9.30±3.56. 5.52±2.26；P=0.001）。年龄[HR 3.919（1.094 - 7.789）；P=0.04]、CT评分[HR 2.352（1.028 - 4.033）；P=0.007]和吸烟史[HR 0.354（0.096 - 0.643）；P=0.03]是死亡的危险因素。
LC-ILD患者术后并发症和死亡率显著增加。非癌性IP区域较高的SUVR通常表明术后并发症增加。较高的CT评分和吸烟史提示预后不良。需要进行随访纵向研究以验证这些发现。
