Clinical characteristics of interstitial lung disease with lung cancer

Abstract

Objective To investigate the clinical characteristics of interstitial lung disease associated with lung cancer (ILD-LC). Methods Sixty-eight patients with lung cancer firstly detected on the basis of diagnosis with interstitial lung disease (ILD) from January 2015 to January 2018 in the First Affiliated Hospital of Zhengzhou University were allocated to ILD-LC group; and 192 patients with ILD firstly detected in the same period were set as ILD group. The differences in general data, tumor markers and lung function between the two groups were retrospectively analyzed and compared, and the characteristics of the ILD-LC group in the high-resolution computed tomography (HRCT) manifestations, pathological types, pathological stages and EGFR gene mutations were analyzed. Results The differences were significant in sex, age, smoking history and smoking index of patients between the ILD-LC group and ILD group (P all<0.05). It was significantly higher in age, male proportion, proportion of smokers and smoking index of patients in the ILD-LC group than those in the ILD group [(65.8±10.5) years vs. (59.5±11.9) years, 86.8% vs. 55.2%, 70.6% vs. 31.8%, 36.71±18.10 vs. 13.47±8.45, P all<0.05]. In the ILD-LC group, the serum levels of CA199, CA125, CEA, NSE and Cyafra21-1 were higher than the normal levels, and the serum levels of CA199, CA125, CEA, NSE and Cyafra21-1 of patients were significantly higher than those in the ILD-LC group [(40.15±10.18) U/ml vs. (20.69±4.53)U/ml, (58.03±11.87) U/ml vs. (35.55±9.55)U/ml, (30.22±2.86) ng/ml vs. (8.25±0.62)ng/ml, (22.14±7.19) ng/ml vs. (14.34±6.20)ng/ml, (10.45±3.45) ng/ml vs. (3.67±1.22) ng/ml, P all<0.05]. The pulmonic dispersion function of the ILD-LC group was worse than the ILD group (P<0.05). The HRCT scan pattern of the ILD-LC patients showed that the UIP-type was the main type in interstitial changes, and the majority of tumors of the ILD-LC group were peripheral lung cancers, located in the lower lobes and the leison of ILD.The pathological types of lung cancer mainly were adenocarcinoma (39.7%)and squamous cell lung cancer (32.4%). On the pathologic stage in the ILD-LC group, non-small cell lung cancer were mainly in Ⅲ(44.9%) or Ⅳ(38.8%) period, and 19 cases were small cell lung cancer in extensive period. Conclusions Elderly, smoking and male ILD patients are more likely to be suffered from lung cancer. Patients with ILD-LC have higher tumor markers and worse lung function than the patients with ILD. Monitoring tumor markers and lung function and regular HRCT examination are helpful for the early diagnosis of ILD-LC. Key words: Interstitial lung disease; Lung cancer; Clinical characteristics