Clinical Features And Correlative Analysis Of COPD Complicated With Lung Cancer

Objective:The clinical characteristics of patients with chronic obstructive pulmonary disease（COPD）complicated by lung cancer and pure COPD were retrospectively analyzed,and the relationship among the anatomical location,lesion location and emphysema as well as emphysema scores with COPD patients complicated by lung cancer were further explored.Methods:A total of 160 patients with COPD complicated by lung cancer and 185COPD patients who were admitted to the Department of Respiratory and Critical Care Medicine,Yijishan Hospital affiliated to Wannan Medical College,between January2018 and January 2021 were selected as objects.Clinical data including age,gender,smoking status,body mass index（BMI）,lung function,pathological type,CT image data,etc.were obtained,the differences in general clinical characteristics between them were analyzed,the correlation among the anatomical location,focus location and emphysema score of COPD patients with incident lung cancer were compared.Results:1.There was statistically significant difference between the two groups in terms of smoking index and emphysema（P<0.001）,while no significant for age,sex ratio,BMI,emphysema score and lung function parameters（P>0.05）.Compared to pure COPD patients,patients with COPD complicated with lung cancer are mostly men,with a higher smoking index and more coexisting emphysema,mostly central cancer and squamous cell carcinoma.2.Among patients with COPD and lung cancer,the emphysema score,FEV₁%,FEV₁/FVC%,and pathological type ratios between patients with central and peripheral lung cancer were significantly different（P<0.05）;When the emphysema scores were divided into four categories or two categories:patients with low emphysema scores（0-2 points）complicated by lung cancer were more likely to develop central cancer（70.34%vs40.48%,P<0.001）,the main pathology is squamous cell carcinoma（57.00%vs38.33%,P<0.001）;and the FEV₁%and FEV₁/FVC%of patients with central lung cancer were significantly lower than that of patients with peripheral lung cancer（P<0.001）;Lesion of patients with high emphysema score（3-4 points）were close to the emphysema（71.43%）,which is 2.50 times（P<0.001）for the proportion far away from emphysema（28.57%）.3.Compared with patients with non-emphysema COPD and lung cancer,patients with emphysema COPD and lung cancer had statistical differences in age,gender,BMI,smoking index,lung function,anatomical location and pathological type（P<0.05）.Men,heavy smoking,low BMI or poor lung function in patients with emphysema COPD complicated by lung cancer were prone to lung cancer and were peripheral and adenocarcinoma.4.Correlation analysis showed that smoking index was significantly positively correlated with emphysema score（r²=0.216,P<0.05）;FEV₁%was significantly negatively correlated with emphysema score（r²=-0.301,P<0.001）.Conclusion:1.The majority of COPD patients with lung cancer are central and squamous cell carcinoma,with emphysema and higher smoking index.2.A low emphysema score is more likely to be complicated with central lung cancer,and the focus is far away from emphysema;while patients with a high emphysema score are more likely to develop peripheral lung cancer,and the focus is mainly near emphysema.3.Lung cancer complicated by COPD patients with emphysema is mainly seen in men,heavy smoking,low BMI and poor lung function,and peripheral and adenocarcinoma are more common.