本文選題：特發(fā)性肺間質(zhì)纖維化 + 肺癌�。� 參考：《浙江大學(xué)》2016年碩士論文

【摘要】：目的了解特發(fā)性肺間質(zhì)纖維化(IPF)合并肺癌(IPF-LC)的臨床和影像學(xué)特點(diǎn)。方法回顧性分析2009年4月—2014年4月在浙江大學(xué)醫(yī)學(xué)院附屬第一醫(yī)院住院期間診斷為IPF-LC的21例患者(IPF-LC組)的臨床、影像學(xué)特點(diǎn),并與同期的23例單純IPF患者(單純IPF組)進(jìn)行比較。結(jié)果IPF-LC組患者平均年齡為(65.2±10.1)歲,平均吸煙指數(shù)為(43.1±27.6)包·年,臨床表現(xiàn)為咳嗽、咳痰15例(71%),氣促18例(86%),咯血4例(19%),腫瘤病理類型以鱗癌11例(52%),腺癌7例(33%)為主,好發(fā)于兩肺下葉(67%)和外周帶(81%),多與網(wǎng)格狀、蜂窩樣結(jié)構(gòu)不相鄰(76%),且均為實(shí)性占位(100%)。IPF-LC組的男性患者比例和吸煙指數(shù)均顯著高于單純IPF組(P值分別0.05、0.01),SaO2水平顯著低于單純IPF組(P0.05),生存時(shí)間顯著短于單純IPF組(P0.05)。綜合21例IPF-LC患者的年齡、是否吸煙、腫瘤分期、血腫瘤標(biāo)志物(血癌胚抗原、血糖類抗原199)、動(dòng)脈血氧分壓(Sa02)等進(jìn)行18個(gè)月生存率的Cox比例風(fēng)險(xiǎn)回歸模型分析,結(jié)果提示除吸煙、低氧血癥外(P值均0.05),其余各因素與生存率均不相關(guān)(P值均0.05)。綜合兩組IPF患者(包括21例IPF-LC和23例單純IPF)的年齡、是否吸煙、血腫瘤標(biāo)志物(血癌胚抗原、血糖類抗原199)、Sa02、是否合并腫瘤等進(jìn)行18個(gè)月生存率的Cox比例風(fēng)險(xiǎn)回歸模型分析,結(jié)果提示合并腫瘤患者預(yù)后差(P0.05),余各因素與生存率均不相關(guān)(P值均0.05)。結(jié)論IPF患者CT上新出現(xiàn)占位需警惕腫瘤的可能。是否合并肺癌影響IPF患者的預(yù)后,而吸煙、低氧血癥與IPF-LC患者生存率存在相關(guān)性。
[Abstract]:Objective to investigate the clinical and imaging features of idiopathic pulmonary interstitial fibrosis (IPF) combined with lung cancer (IPF-LC). Methods the clinical and imaging features of 21 patients with IPF-LC diagnosed in the first affiliated Hospital of Zhejiang University Medical College from April 2009 to April 2014 were retrospectively analyzed. The results were compared with 23 patients with IPF alone (IPF group) in the same period. Results the average age of patients in IPF-LC group was 65.2 鹵10.1 years, and the average smoking index was 43.1 鹵27.6 years. The clinical manifestations were cough, sputum in 15 cases, sputum in 71 cases, dyspnea in 18 cases, hemoptysis in 4 cases, squamous cell carcinoma in 11 cases and adenocarcinoma in 7 cases. Most often occurring in the lower lobe of both lungs) and in the peripheral zone of 81C, mostly gridded. The percentage and smoking index of male patients with nonadjacent honeycomb structure were significantly higher than that of IPF group (P = 0.050.01), respectively, and the survival time was significantly shorter than that of IPF group (P 0.05). Age, smoking, tumor stage, blood tumor markers (carcinoembryonic antigen, carbohydrate antigen 199g, arterial oxygen partial pressure Sa02) of 21 patients with IPF-LC were analyzed by Cox proportional regression model. The results showed that smoking was excluded. All the other factors were not correlated with survival rate (P = 0.05). The age, smoking, tumor markers (carcinoembryonic antigen, carbohydrate antigen 199-Sa02, tumor associated with tumor) of the two groups of IPF patients (including 21 cases of IPF-LC and 23 cases of simple IPF) were analyzed by using the Cox proportional risk regression model for the survival rate of 18 months. The results suggested that the prognosis of patients with tumor was poor (P 0.05), and the other factors were not correlated with survival rate (P = 0.05). Conclusion the new occurrences on CT in IPF patients need to be alert to the possibility of tumor. The prognosis of patients with IPF was affected by lung cancer, while smoking and hypoxemia were associated with survival rate of IPF-LC patients.
【學(xué)位授予單位】：浙江大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2016
【分類號(hào)】：R563;R734.2

【相似文獻(xiàn)】

相關(guān)期刊論文 前10條

1 雷雯,李其皓,張濤,王穎;慢性阻塞性肺疾病合并肺癌48例臨床分析[J];現(xiàn)代診斷與治療;2001年02期

2 黃基格,陳彥凡;慢性阻塞性肺疾病合并肺癌62例臨床分析[J];浙江臨床醫(yī)學(xué);2003年02期

3 程飛;姜濤;;2型糖尿病合并肺癌的臨床特點(diǎn)分析[J];臨床醫(yī)學(xué);2006年02期

4 \∫昂，

本文編號(hào)：1888194