特发性肺间质纤维化与肺癌共病患者的临床诊疗及研究进展

Clinical Diagnosis, Treatment and Research Progress in Patients with Comorbidity of Idiopathic Pulmonary Fibrosis and Lung Cancer

摘要: 目的：探讨特发性肺间质纤维化(Idiopathic Pulmonary Fibrosis, IPF)与肺癌(Lung Cancer, LC)之间的关联性，分析二者共病的临床特征及最新研究进展，并总结其诊治策略与预后管理方法。方法：基于目前最新研究进展及大量流行病学证据，分析IPF与LC在危险因素、临床特征、发病机制、诊疗等方面的相似性，并综述二者共病在临床诊疗中的影响因素、治疗选择及预后特点。结果：IPF是LC的独立危险因素，LC亦是IPF的常见并发症。流行病学研究数据显示，IPF患者发生肺癌的风险显著高于普通人群，据研究统计，IPF患者中肺癌的发病率在2.8%至17.16%之间，且IPF患者发生肺癌的风险比普通人群高出5倍以上，故对于IPF-LC共病患者的临床诊疗需综合考虑疾病急性加重风险、肿瘤分期及基础肺功能等方面因素，在多学科诊疗(MDT)框架基础下制定个体化治疗方案，并加强诊疗过程中不良事件监测与定期随访，部分患者可辅以肺康复及个体化功能锻炼。目前，IPF合并LC患者病死率高，预后极差。结论：IPF与LC共病的临床诊治需重视个体化策略与多学科协作，未来仍需探索更多的临床试验以建立更加安全有效的治疗方案，改善患者疗效及预后。

Abstract: Objective: To investigate the association between Idiopathic Pulmonary Fibrosis (IPF) and Lung Cancer (LC), analyze the clinical characteristics and latest research progress of their comorbidity, and summarize their diagnosis, treatment strategies and prognosis management methods. Methods: Based on a large amount of epidemiological evidence, the similarities between IPF and LC in terms of risk factors, clinical characteristics, pathogenesis, diagnosis and treatment were analyzed, and the influencing factors, treatment options and prognostic characteristics of the two co-diseases in clinical diagnosis and treatment were reviewed. Results: IPF is an independent risk factor for LC, and LC is also a common complication of IPF. Epidemiological research data show that the risk of developing lung cancer in IPF patients is significantly higher than that in the general population. According to research statistics, the incidence of lung cancer in IPF patients is between 2.8% and 17.16%, and the risk of developing lung cancer in IPF patients is more than 5 times higher than that in the general population. Therefore, the clinical diagnosis and treatment of patients with IPF-LC comorbidity needs to comprehensively consider factors such as the risk of acute exacerbation of the disease, tumor stage and basic lung function. Based on the multidisciplinary diagnosis and treatment (MDT) framework, individualized treatment plans should be developed with strengthened adverse event monitoring and regular follow-up during the process. Some patients can be supplemented with lung rehabilitation and individualized functional exercise. At present, patients with IPF complicated with LC have a high mortality rate and a very poor prognosis. Conclusion: The clinical diagnosis and treatment of comorbidity of IPF and LC requires attention to individualized strategies and multidisciplinary collaboration. In the future, more clinical trials need to be explored to establish a safer and effective treatment plan and improve patient efficacy and prognosis.