P2.11-20 Risk Factors of Lung Cancer Development in IPF Patients

Abstract

Idiopathic pulmonary fibrosis (IPF) is known as a risk factor for lung cancer (LC) by several previous studies, and that the presence of LC shortens survival in patients with IPF. However, the risk factors for the development of LC after the diagnosis of IPF have not been fully evaluated. We investigated the predictive factors for LC by longitudinal cohort analysis. This was a retrospective study of a single center interstitial lung disease cohort. Study patients were consecutively enrolled to the cohort between March 2006 and December 2018 at Bucheon St. Mary’s Hospital, The Catholic University of Korea. This cohort study consists of 102 patients with IPF, and the incidence of LC and the outcomes were investigated. During the mean follow-up periods of 62.7 months, 27 patients (26%) developed LC. The most frequent cell type was Squamous cell carcinoma, and the proportion of male was higher in IPF-LC group (92.6% vs 70.7%, p=0.021). In univariate cox regression analysis, low forced vital capacity (FVC) <75% (p<0.001), and low diffusion capacity of the lungs for carbon monoxide (DLco) <55% (p<0.001) was associated with LC development. In Cox proportional hazards model, low FVC (hazard ratio [HR]: 5.65; 95% confidence interval [CI]: 1.78-17.84, p=0.003) and low DLco (HR: 27.5; 95% CI: 1.97-386.6, p=0.014) were independent predictive factors for LC in stepwise multivariate analysis. Low FVC and Low DLco, which are pulmonary function parameters reflecting their severity of IPF, are suggested as independent risk factors for LC development in IPF patients.