The Clinical Features And Therapeutic Schedule Of Interstitial Lung Disease Combined With Lung Cancer

Background:On the basis of interstitial lung disease,the incidence rate of lung cancer is obviously increased.In clinical treatment,patients with interstitial lung disease and lung cancer often appear.In the treatment of these patients,there is a risk of exacerbation of interstitial lung disease and even death of patients.Therefore,we should raise awareness of the disease early and explore the most favorable treatment plan to improve the prognosis of patients.It is important to reduce the clinical mortality.Objective:The purpose of this study is to summarize the clinical characteristics of interstitial lung disease with lung cancer,improve the cognition of ILD-LC,and achieve early detection,early diagnosis and early treatment in clinical practice,so as to reduce the rate of missed diagnosis and misdiagnosis,thus improving the quality of life of patients and prolonging their life.Method:Retrospective analysis was performed on 50 patients with interstitial lung disease（ILD）and 50 patients with simple lung cancer（LC）who were admitted to China-Japan Union Hospital of Jilin University from January 2010 to December 2019.At the same time,the clinical data of 44 patients with interstitial lung disease combined with lung cancer（ILD-LC）were analyzed retrospectively.Statistical analysis was performed on the medical history,clinical symptoms and auxiliary examinations of patients in the three groups,mainly including patients’gender,age,smoking history,first symptom,tumor location,diagnostic means,and tumor marker level.Statistical analysis was performed using SPSS25.Results:1.There were 33（75%）smoking patients and 32（72.7%）male patients in ILD-LC group,and the age of onset was 69.23±9.203 years old,which was significantly higher than that in ILD group,and the difference was statistically significant（P<0.05）.2.Compared with ILD group,the symptoms of hemoptysis and dyspnea were more obvious,and the proportion of clubbing fingers was more.Compared with the ILD-LC group,the proportion of hemoptysis was less,and the proportion of double lung burst was higher,with statistical significance（P<0.05）.3.The levels of CA125,CYFRA21-1,CA199 and CEA in ILD-LC group were30.55（13.88,60.60）U/ml,4.46（2.62,7.92）ng/ml,14.81（6.26,21.30）U/ml,4.39（2.38,9.51）ng/ml,respectively,which were significantly higher than those in ILD group（P<0.05）.4.The incidence of pulmonary hypertension in ILD-LC group was 52.27%,and that in LC group was 28%,which was significantly higher in ILD group than in LC group（P<0.05,with statistical significance）.5.In ILD-LC group,there were 8（18.2%）cases of small cell carcinoma,16（36.3%）cases of adenocarcinoma,19（43.2%）cases of squamous cell carcinoma,and1（2.3%）cases of other non-small cell carcinoma.In the LC group,there were 10（20%）cases of small cell lung cancer,24（48%）cases of adenocarcinoma,14（28%）cases of squamous cell carcinoma,and 2（4%）cases of other non-small cell carcinoma.Histological classification of the two groups was counting data,using chi-square test to statistic P>0.05,the difference was not statistically significant.6.PO₂in ILD-LC group was 61.25±10.85,significantly lower than that in LC group,and the difference was statistically significant（P<0.05）.7.The lung tumors in ILD-LC group were mostly distributed in the subpleural pulmonary fibrosis area.Lung malignant tumors occurred in 16 cases of upper lobe,22 cases of lower lobe,6 cases of middle lobe,21 cases of mediastinum invasion,23cases of lymph node enlargement.8.Among ILD-LC patients,1 case was treated with gamma knife.Surgical resection was performed only in 1 case.6 cases underwent chemotherapy after surgical resection.Three patients received surgical resection,chemotherapy combined with immunotherapy.12 cases were treated with chemotherapy only.2 underwent radiotherapy after chemotherapy;5 underwent targeted therapy;One case was treated with simple immunotherapy.1 case of immunotherapy combined with chemotherapy.Conclusions:1.ILD-LC is more common in elderly,smokers and male patients.2.ILD-LC clinical manifestations are not typical,but dyspnea,cough is common,ILD patients appear hemoptysis,dyspnea aggravation,vigilance may be combined with lung cancer.3.ILD-LC tumor markers are of great significance for the diagnosis of ILD-LC,and the increase of CEA,CA125,CA199 and CYFRA21-1 is beneficial for the diagnosis.4.ILD-LC was more common in the lower lobe of lung,and squamous cell carcinoma was the most common pathological type.5.ILD-LC has low blood oxygen content,significantly impaired lung function and poor prognosis.Therefore,individualized treatment should be selected by combining blood gas analysis and pulmonary artery pressure.