Clinical And Imaging Characteristics Of Idiopathic Pulmonary Fibrosis Combined With Lung Cancer

ObjectiveTo study the clinical and imaging features of idiopathic pulmonary fibrosis combined with lung cancer(IPF-LC).MethodsWe retrospectively recruited 21 patients who had been admitted into The First Affiliated Hospital,Zhejiang University School of Medcine.from April 2009 to April 2014 and diagnosed as IPF-LC while a total of 23 IPF patients without LC was served as a control group.Clinical and demographic features of these two groups were analyzed respectively and then summarized and compared.ResultsIPF-LC group was comprised of 20 males and 1 female.Within the IPF-LC group,average age was(65.2±10.1)years,mean smoking index was 43.1 pack-years,the clinical manifestation were cough(71%),shortness of breath(86%),and hemoptysis(19%),the main pathological types of LC were squamous carcinoma(52%)and adenocarcinoma(33%),and were basically solid space-occuping lesion(100%),most of which were not adjacent to the honeycomb-shaped pulmonary structure.The LC were predominately arised in the inferior lobes(67%)and peripheral region(81%)of bilateral lungs.IPF-LC group has a significantly higher percentage of male(P<0.05),smoking index,(P<0.01)and lower SaO2 level(P<0.05),shorter overall survival(P<0.05)when compared with IPF patients without LC.Cox proportional hazards models indicated that among the 21 IPF-LC patients,smoking history and lower SaO2 level were statistically corelated(p<0.05)to a shorter overall survival.Nevertheless,we found that among the 44 patients(IPF-LC and IPF),IPF patients complicated with cancer had worse clinical outcome.Smoking,tumor markers serum levels(CEA,CA-199),SaO2 level were not related to overall survival.(p>0.05).Conclusion Newly found space-occuping lesions by chest computed tomography in IPF patients is a risk factor for LC which predict a poor clinical prognosis.Smoking,lower SaO2 level were significantly correlated to the overall survival rate of IPF-LC patients.