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肺癌与慢性阻塞性肺疾病的共病:相关性及治疗策略的优化

Comorbidity of lung cancer and chronic obstructive pulmonary disease: correlation and optimization of treatment strategies.

作者信息

Jiang Huixin, Huang Gengda, Feng Du, Plönes Till, Young Robert P, Salehi-Rad Ramin, Liu Qibo, Meng Ying, Zhou Chengzhi

机构信息

Department of Respiratory and Critical Care Medicine, State Key Laboratory of Respiratory Disease, National Clinical Research Center for Respiratory Disease, National Center for Respiratory Medicine, Guangzhou Institute of Respiratory Health, the First Affiliated Hospital of Guangzhou Medical University, Guangzhou, China.

Nanshan School, Guangzhou Medical University, Guangzhou, China.

出版信息

Transl Lung Cancer Res. 2025 Jun 30;14(6):2296-2308. doi: 10.21037/tlcr-2025-480. Epub 2025 Jun 13.

Abstract

Chronic obstructive pulmonary disease (COPD) and lung cancer (LC) are two major global public health challenges, both characterized by high incidence and mortality rates. Given that COPD and LC share many common risk factors, they frequently coexist, further exacerbating the overall disease burden. The comorbidity of COPD and LC not only increases the risk of both conditions, but also reflects the complex pathophysiological relationship between them. This relationship involves mechanisms such as oxidative stress, chronic inflammation, immune dysregulation, and cellular senescence, which collectively contribute to the development of LC and the progression of COPD. Recent studies have shown that patients with COPD are significantly more likely to develop LC, while the presence of LC may also worsen COPD symptoms and accelerate its progression. This dual impact not only places an additional physiological burden on patients but also complicates the clinical management of these diseases. This study sought to summarize the epidemiological characteristics, comorbidity mechanisms, and key risk factors associated with COPD and LC. It also aimed to explore the shared pathophysiological mechanisms underlying both diseases, highlighting the complex and multifaceted nature of their comorbidity. Additionally, it sought to summarize individualized intervention strategies to reduce the reciprocal impact of both conditions, improve patients' quality of life, and provide scientific evidence for clinical practice, ultimately offering more effective solutions to the growing healthcare challenges posed by this comorbidity.

摘要

慢性阻塞性肺疾病(COPD)和肺癌(LC)是全球两大主要的公共卫生挑战,二者均具有高发病率和高死亡率的特点。鉴于COPD和LC有许多共同的危险因素,它们常常同时存在,进一步加重了整体疾病负担。COPD和LC的合并症不仅增加了两种疾病的发病风险,还反映了它们之间复杂的病理生理关系。这种关系涉及氧化应激、慢性炎症、免疫失调和细胞衰老等机制,这些机制共同促成了LC的发生和COPD的进展。最近的研究表明,COPD患者患LC的可能性显著更高,而LC的存在也可能使COPD症状恶化并加速其进展。这种双重影响不仅给患者带来了额外的生理负担,也使这些疾病的临床管理变得复杂。本研究旨在总结与COPD和LC相关的流行病学特征、合并症机制及关键危险因素。它还旨在探索这两种疾病共同的病理生理机制,突出其合并症的复杂性和多面性。此外,它试图总结个体化干预策略,以减少两种疾病的相互影响,提高患者的生活质量,并为临床实践提供科学依据,最终为这种合并症带来的日益严峻的医疗挑战提供更有效的解决方案。

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