CAJ | 학술논문

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、刺激性于咳、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.结论间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.
목적 탐토간질성폐병합병폐암환자적림상특점,이제고림상진치수평.방법 대8례경병리학진적간질성폐병합병폐암환자적림상표현、영상학、병리진행분석,치료후수방.결과 8례환자중남성6례,녀성2례,6례유흡연사,중위년령64세.주요림상증상위각혈、자격성우해、해대량포말담、흉민기단가중.3례유면역학지표양성.영상학표현위연흉막하분포위주적세망격급봉와폐,반폐내결절.간질성폐병류형위비특이성간질성폐염급심상형간질성폐염;폐암이선암위주.2례ANCA양성적환자급여당피질격소치료;5례환자행폐암근치술,기중3례환자무법내수술후화료,2례환자술후급여보조화료,1례행단순화료후출현중도골수억제사망.령2례환자방기진일보치료,분별우학진후8개월급10개월사망.결론 간질성폐염합병폐암기병은닉,용역오진、루진,림상응인기고도중시.
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.