摘要
目的探讨间质性肺病合并肺癌患者的临床特点，以提高临床诊治水平。方法对8例经病理确诊的间质性肺病合并肺癌患者的临床表现、影像学、病理进行分析，治疗后随访。结果8例患者中男性6例，女性2例，6例有吸烟史，中位年龄64岁。主要临床症状为咯血、刺激性干咳、咳大量泡沫痰、胸闷气短加重。3例有免疫学指标阳性。影像学表现为沿胸膜下分布为主的细网格及蜂窝肺，伴肺内结节。间质性肺病类型为非特异性间质性肺炎及寻常型间质性肺炎；肺癌以腺癌为主。2例ANCA阳性的患者给予糖皮质激素治疗；5例患者行肺癌根治术，其中3例患者无法耐受术后化疗，2例患者术后给予辅助化疗，1例行单纯化疗后出现重度骨髓抑制死亡。另2例患者放弃进一步治疗，分别于确诊后8个月及10个月死亡。结论问质性肺炎合并肺癌起病隐匿，容易误诊、漏诊，临床应引起高度重视。
Objective To investigate the clinical features of interstitial lung disease associated with lung cancer. Methods The clinical manifestations, chest radiography, and pathology of eight interstitial lung disease associated with lung cancer patients were analyzed. All cases were followed up after treatment. Results The patients included six males and two females, six cases had history of smoking, three cases had positive immunological markers. The main clinical symptoms were hemoptysis, dry cough, frothy sputum,and shortness of breath. The pathological types of interstitial lung disease were usual interstitial pneumonia and nonspecific interstitial pneumonia. The pathological type of lung cancer was mainly adenocarcinoma. Five cases were treated with radical resection, three cases of them were unable to tolerate postoperative chemotherapy, two cases of them were given adjuvant chemotherapy. One case was died of severe bone marrow suppression after chemotherapy. The other two cases abandoned further treatment and died at eight months and ten months after diagnosis, respectively. Conclusions Interstitial lung disease associated with lung cancer is usually occult in onset and should be paid attention.
出处
《国际呼吸杂志》
2013年第24期1848-1851,共4页
International Journal of Respiration
关键词
间质性肺病
肺癌
临床特点
误诊
Interstitial lung disease
Lung cancer
Clincal manifestations
Misdiagnosis
