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特发性肺纤维化相关肺癌的发病机制与治疗现状

Pathogenesis and current status of the treatment of lung cancer associated with idiopathic pulmonary fibrosis.

作者信息

Zhang Yuanyuan, Qi Chang, Wei Qi, Li Yalun, Tian Panwen

机构信息

Department of Pulmonary and Critical Care Medicine, State Key Laboratory of Respiratory Health and Multimorbidity, Institute of Respiratory Health and Multimorbidity, Institute of Respiratory Health, Frontiers Science Center for Disease-related Molecular Network, Precision Medicine Center/Precision Medicine Key Laboratory of Sichuan Province, West China Hospital, Sichuan University, Chengdu, Sichuan, China.

Lung Cancer Center/Lung Cancer Institute, West China Hospital, Sichuan University, Chengdu, Sichuan, China.

出版信息

Respir Res. 2025 Jul 2;26(1):230. doi: 10.1186/s12931-025-03294-7.

Abstract

Idiopathic pulmonary fibrosis (IPF) is an interstitial lung disease with chronic progressive fibrosis of unknown etiology; it is characterized by persistent fibrosis of the lungs accompanied by irreversible lung function decline and high mortality rates. A large body of evidence suggests a significant association between IPF and lung cancer (LC). IPF itself increases the risk of LC development, and LC associated with IPF often originates in areas of honeycomb lesions in IPF. In addition, there are similarities between the two diseases in terms of genetics as well as cellular molecular mechanisms; examples include genetic and epigenetic variants, fibroblast activation and proliferation, epithelial‒mesenchymal transition (EMT), abnormal mechanical forces generated in the lungs, and aberrant signaling pathway activation, which may drive the progression of pathology in both diseases. In this review, we describe in detail the epidemiological and clinical associations of LC in patients with IPF, highlight recent studies on the shared pathogenesis between IPF and LC, and discuss current advances in the treatment of LC associated with idiopathic pulmonary fibrosis.

摘要

特发性肺纤维化(IPF)是一种病因不明的间质性肺疾病,其特征是肺部慢性进行性纤维化,伴有不可逆的肺功能下降和高死亡率。大量证据表明IPF与肺癌(LC)之间存在显著关联。IPF本身会增加患LC的风险,与IPF相关的LC通常起源于IPF的蜂窝状病变区域。此外,这两种疾病在遗传学以及细胞分子机制方面存在相似之处;例如基因和表观遗传变异、成纤维细胞活化和增殖、上皮-间质转化(EMT)、肺部产生的异常机械力以及异常信号通路激活,这些可能推动两种疾病的病理进展。在本综述中,我们详细描述了IPF患者中LC的流行病学和临床关联,强调了关于IPF和LC共同发病机制的最新研究,并讨论了特发性肺纤维化相关LC治疗的当前进展。

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