Yan Liu1,2, Min Zhu2, Jing Geng3, Chengjun Ban2, Shu Zhang2, Wenhui Chen3, Yanhong Ren3, Xuan He3, Wang Chen3, Huaping Dai2,3. 1. Department of Infectious Disease, Beijing Anzhen Hospital, Capital Medical University, Beijing, China. 2. Department of Respiratory and Critical Care Medicine, Beijing Chao-Yang Hospital, Capital Medical University, Beijing, China. 3. Department of Pulmonary and Critical Care Medicine, Center for Respiratory Diseases, China-Japan Friendship Hospital; National Clinical Research Center for Respiratory Diseases, Beijing, China.
Abstract
OBJECTIVE: To investigate the incidence and risk factors of lung cancer in patients with idiopathic pulmonary fibrosis (IPF), and to learn the clinical, imaging and pathological features and of lung cancer in IPF. METHODS: The study population included consecutive 268 IPF patients. Of them, 46 patients had pathologically or cytologically proven lung cancer. The demographic, clinical, HRCT and pathological features in patients with IPF and lung cancer were analysed and compared with the patients with IPF alone. RESULTS: Of 268 IPF patients, 46 patients were diagnosed as IPF with lung cancer, accounted for 17.16%. 45.65% were adenocarcinoma. Lung cancer located mostly in the peripheral area and lower lobes of lungs consistent with IPF affected area. Old age and heavy smoking were risk factors of lung cancer developing in IPF. Chest pain and haemoptysis were more frequent in IPF patients with lung cancer than without lung cancer (P = .000). Nodular or mass shadows were found only in IPF patients with lung cancer (P = .000). The levels of CEA and CA125 in IPF patients were much higher in IPF patients with lung cancer (P ≤ .001). The median survival time was 36.2 ± 22.7 months in IPF patients, longer than 6.9 ± 3.3 months in IPF patients with lung cancer (P < .001). CONCLUSIONS: Lung cancer frequently develops in patients with IPF, which is mainly adenocarcinoma, located in IPF affected area. Chest pain and haemoptysis are potential indicative of lung cancer developing in patients with IPF as atypical nodes or masses located in the peripheral areas and lower lobes on chest HRCT.
OBJECTIVE: To investigate the incidence and risk factors of lung cancer in patients with idiopathic pulmonary fibrosis (IPF), and to learn the clinical, imaging and pathological features and of lung cancer in IPF. METHODS: The study population included consecutive 268 IPF patients. Of them, 46 patients had pathologically or cytologically proven lung cancer. The demographic, clinical, HRCT and pathological features in patients with IPF and lung cancer were analysed and compared with the patients with IPF alone. RESULTS: Of 268 IPF patients, 46 patients were diagnosed as IPF with lung cancer, accounted for 17.16%. 45.65% were adenocarcinoma. Lung cancer located mostly in the peripheral area and lower lobes of lungs consistent with IPF affected area. Old age and heavy smoking were risk factors of lung cancer developing in IPF. Chest pain and haemoptysis were more frequent in IPF patients with lung cancer than without lung cancer (P = .000). Nodular or mass shadows were found only in IPF patients with lung cancer (P = .000). The levels of CEA and CA125 in IPF patients were much higher in IPF patients with lung cancer (P ≤ .001). The median survival time was 36.2 ± 22.7 months in IPF patients, longer than 6.9 ± 3.3 months in IPF patients with lung cancer (P < .001). CONCLUSIONS:Lung cancer frequently develops in patients with IPF, which is mainly adenocarcinoma, located in IPF affected area. Chest pain and haemoptysis are potential indicative of lung cancer developing in patients with IPF as atypical nodes or masses located in the peripheral areas and lower lobes on chest HRCT.