在患有同时出现肺癌和异常性肺纤维化患者中,术后急性恶化和长期生存的危险因素
Zhaoxun Li1, Yingran Shen1, Jie Dai1
1Department of Thoracic Surgery, Shanghai Pulmonary Hospital, School of Medicine, Tongji University, Shanghai, China.
Annals of surgical oncology
|January 9, 2026
概括
患有严重异常性肺纤维化 (IPF) 且接受肺癌手术的患者面临更高的急性恶化 (AE) 风险和更差的生存率. 预防性类固醇可能会减少AE,但不会改善长期结果.
科学领域:
- 肺部病理学 肺部病理学
- 胸部外科手术 胸部外科手术
- 在瘤学瘤学.
背景情况:
- 异形性肺纤维化 (IPF) 是一种渐进的肺部疾病.
- 同时肺癌和IPF (LC-IPF) 提出了独特的治疗挑战.
- 手术后急性恶化 (AE) 是LC-IPF患者的一个重大问题.
研究的目的:
- 在LC-IPF患者中确定术后AE的危险因素.
- 评估影响LC-IPF患者整体存活时间 (OS) 的预后因素.
- 评估预防性类固醇使用对AE和OS的影响.
主要方法:
- 对382名LC-IPF患者进行瘤切除的回顾性分析.
- 具有和没有AE的患者之间的临床特征和结果的比较.
- 后勤和考克斯回归分析以确定风险和预后因素.
主要成果:
- 5.0%的患者患有术后AE;2.9%的30天死亡率.
- 严重的IPF (>50%的肺部参与) 显著增加了AE风险 (29.4%对3.8%).
- 严重的IPF和降低的DLCO与较差的OS有关;预防性类固醇没有显示OS益处.
结论:
- 严重的IPF是术后AE和LC-IPF的不良预后的关键风险因素.
- 预防性类固醇可能会降低AE发生率,但不会改善长期存活率.
- 对这种高风险的LC-IPF群体来说,个性化的术后管理是必不可少的.
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