The Prognostic Impact Of Combined Pulmonary Fibrosis And Emphysema In Patients With Non-surgical Lung Cancer

Objective:To investigate the effect of pulmonary fibrosis with emphysema(CPFE)on the prognosis of patients with non-surgical lung cancer.Methods:From January 2013 to December 2015,272 patients with non-surgical lung cancer were selected from the first hospital of Lanzhou University in Gansu Province.According to the clinical imaging data,they were divided into lung cancer and non simple lung cancer.CPFE group,pulmonary fibrosis group and pulmonary emphysema group were selected from non simple lung cancer,and then the survival data of patients were obtained through further follow-up.To compare the difference between CPFE group and other groups,K-M method was used for survival analysis and log rank test,Cox risk proportional regression model was used for further prognosis analysis.The best critical value of prognosis was determined by ROC curve of lung function.Results:(1)The main clinical and pathological characteristics of CPFE with lung cancer:181 cases(66.5%)in lung cancer group,23 cases(8.5%)in lung cancer group,8 cases(2.9%)in pulmonary fibrosis with lung cancer group and 60 cases(22.1%)in emphysema with lung cancer group.All the men in the CPFE group with lung cancer had an average age of 64.6?12.8 years,an average BMI of 22.8?2.4kg/m~2,an average pulmonary artery pressure of 42.7?4.1mmHg,and the most common lesions were squamous cell carcinoma.(2)The clinical characteristics and pathological factors of CPFE combined with lung cancer group were compared with other groups:compared with lung cancer alone,CPFE combined with lung cancer was more common in men with smoking history and older age group,and the tumors were mostly in the lower lobe of the lung.The main percutaneous lung puncture mode was detected,and TLC and DLCO were lower,with significant difference(P<0.001).There was significant difference in tumor location between the two groups(P<0.001).(3)Survival analysis:the median survival time of CPFE patients with lung cancer was10 months,which was shorter than that of other groups except pulmonary fibrosis group(P<0.05).(4)Age,clinical stage and CPFE are important risk factors for prognosis of lung cancer.(5)Relationship between lung function and prognosis of lung cancer:DLCO of CPFE patients with lung cancer was significantly lower than that of other groups(P<0.001).FVC,RV and DLCO were independent risk factors affecting the prognosis of patients with non-surgical lung cancer(P<0.05).The overall prognosis of patients in low FVC group and low DLCO is more worse.Conclusion:1.Age,gender,tumor location,smoking index,TLC and DLCO are mainly related to CPFE in lung cancer.2.CPFE is significantly related to the prognosis of patients with non-surgical lung cancer.The overall prognosis of patients with lung cancer and CPFE is worse.