Analysis Of Clinical Characteristics Of Patients With Lung Cancer In Idiopathic Pulmonary Fibrosis

Objective:Lung cancer is one of the common complications in idiopathic pulmonary fibrosis(IPF)patients.,which has poor prognosis and high mortality.This study was aimed to analyze the clinical characteristics of patients with idiopathic pulmonary fibrosis(IPF).Lung cancer associated with idiopathic pulmonary fibrosis(IPF-LC),including gender,age,smoking index,clinical symptoms,signs,lung function,tumor markers,imaging findings,tumor classification,staging and differentiation,providing early diagnosis and evaluation for clinicians to predict possible reference for idiopathic pulmonary fibrosis with lung cancer.Methods:The present study performed 150 patients with IPF?23 patients with IPF-LC admitted in the First and Second Affilicated Hospital of Dalian Medical University from January 2011 to January 2017.Analysis of clinical characteristics of the above two groups of patients,including gender,age,smoking index,clinical symptoms,signs,lung function,tumor markers,imaging findings,tumor classification,staging and differentiation and so on.In this study,tumor staging was combined into I-II,III-IV.The statistical data of the collected samples were normalized Continuous variables are presented as the X±s,and t test was uesd between groups.The non-normal distribution of the measured data and the rate was measured by rank sum test and chi-square test.P values<0.05 were considered statistically significant.Results:1.The proportion of lung cancer in IPF patients was 13.3%,significantly higher than in the general population.2.The age of the patients in the IPF group was(67.25 ± 8.622)years and 123 cases(82%)were male,The age of the patients in the IPF-LC group was(69.52 ± 6.728)years and 21 cases(91.3%)were male.There was no significant difference in gender and age distribution between two groups.Male patients were more common in all groups.3.The proportion of the two age groups aged 40-64 years,65 years or older in the IPF group was 44%and 56%respectively,and the ratio of the two age groups in the IPF-LC group was 21.7%,78.3%The difference between the IPF group and the IPF-LC group was statistically significant(P<0.05).4.The smoking index of IPF and IPF-LC were 800(0,2000),1200(0,3000),respectively.The smoking index of IPF-LC was significantly higher than IPF group,the difference was statistically' significant(P<0.05).5.In the IPF group,there were 11 cases(8.7%)of the patients with hemoptysis,11 patients(7.3%)with chest pain,25 cases(16.7%)were weight loss,IPF-LC group of patients with hemoptysis in 7 cases(30.4%),chest pain were 6(26.1%),and weight loss were 8 cases(34.8%),and there was significant difference between the two groups(P<0.05).There was no statistically significant difference between IPF and IPF-LC in other clinical manifestations.6.There were 11 cases(47.8%)of patients with pleural effusion in IPF-LC group,which were significantly higher than those in IPF group(P<0.05).In the distribution of tumor,IPF-LC group was mainly distributed in the lower lobes(48%)and peripheral(76.2%).7.The levels of CEA,CYFRA21-1 and NSE in serum of IPF-LC group were 24.68(0.89,1000)ng/ml?10.71(2.33,124.8)ng/ml.10.64(2.2,119.8)U/ml,respectively,which were significantly higher than IPF Group,the difference was statistically significant(P<0.05).8.IPF-LC patients with squamous cell carcinoma was 26.1%,adenocarcinoma was 56.5%,and the low differentiated carcinoma accounted for 87%.Conclusion:1.The incidence of lung cancer in IPF patients was significantly higher than in the general population.2.Elderly male with higher smoking index in IPF-LC patients is more common.3.IPF-LC patients with hemoptysis,chest pain and weight loss is more common than those without lung cancer in IPF patients.4.Lung cancer location in patients with IPF commonly occurs in the lower lobes and periphera,and prone to pleural effusion.5.The levels of CEA,CYFRA21-1 and NSE in IPF-LC patients were significantly higher than those in IPF group,which could be used as a preliminary basis for assisting in the diagnosis of IPF-LC.6.Adenocarcinoma and squamous cell carcinoma are the commonly histotype in IPF-LC patients and the differentiation degree is low.