Comparative Analysis Of Invasive Pulmonary Fungal Infection In Solid Malignant Tumors And Hematological Tumors

Objective:Compare and analyze the incidence,risk factors,clinical features and antifungal treatment results of invasive pulmonary fungal infection(IPFI)in patients with solid malignant tumors and hematological tumors,to improve the understanding of diagnosis and treatment of invasive pulmonary fungal infections.Methods:We retrospectively analyze clinical data of patients with solid malignant tumors or hematological tumors with invasive pulmonary fungal infection and antifungal treatment from June 2017 to June 2019,Shenzhen Hospital of the Chinese Academy of Medical Sciences Cancer Hospital.We compared risk factors,clinical characteristics,response rate to antifungal therapy,and median time to medication between the two group.Results:There were 30 patients with solid malignant tumors combined with IPFI,the incidence rate was 0.42%.There were 228 patients with hematological tumors combined with IPFI,the incidence rate was 10.6%.The difference was statistically significant(P<0.05).The proportion of males in the solid malignant tumor group were 33.3%(10/30).The proportion of males in the hematological tumor group were61.4%(140/228).Multivariate analysis of statistically significant differences in neutrophihic status,history of steroid therapy,history of diabetes,history of chronic lung disease,symptoms of cough and sputum,positive rate of G/GM test,and positive rate of microbial culture.There were no significant differences between the two group in age above 65 years,fever,dyspnea,and characteristic imaging features of the lungs.The proportion of combined antifungal therapy in the hematological tumor group was 35.1%(80/228),but not in the solid malignant tumor group.We compared the results of monotherapy group and the combination therapy group with the hematological tumor.The median treatment time in the two groups was 17.89±7.738 days and 13.55±5.176 days,and the effective rate was 61.5%(91/148)and 75%(60/80).The difference was statistically significant(P <0.05).Conclusion:Invasive pulmonary fungal infections have higher incidence in patients with hematological tumors.The efficacy of hematological tumors combined with antifungal therapy is accurate and safe,which deserves further clinical application in solid malignancies tumors.