Clinical characteristics and survival analysis of 43 cases presenting with the coexistence of interstitial lung disease with lung cancer

SHEN Lan-ying; ZHANG Yan; HU Yue

doi:10.19538/j.nk2025060110

Abstract：Objective To explore the clinical characteristics of patients diagnosed with both interstitial lung disease and lung cancer(ILD-LC)and make survival analysis.Methods The clinical data of 43 patients with ILD-LC,81 patients with interstitial lung disease(ILD)and 341 patients with lung cancer(LC)who received treatment at the Second Affiliated Hospital of Zhejiang University School of Medicine from January 2016 to August 2021 were selected.The survival curve was generated using the Kaplan-Meier method.A Cox proportional hazards model was employed to analyze multiple factors influencing survival.Results The age of onset in the ILD-LC group was 66.74±8.49 years,with 36 cases(83.72％)being male and 31(72.09％)being smokers.Additionally,CEA was higher in the ILD-LC group than in the ILD group and LC group(Z=-4.251,P＜0.001;Z=-4.120,P＜0.001),and so were CA199(Z=-3.823,P＜0.001;Z=-4.770,P＜0.001),CA125(Z=-3.234,P=0.001;Z=-4.502,P＜0.001),CA242(Z=-4.109,P＜0.001;Z=-4.560,P＜0.001),CYFRA21-1(Z=-2.565,P=0.010;Z=-3.318,P=0.001),NSE(Z=-4.576,P＜0.001,Z=-3.143,P=0.002)and SCC(Z=-3.227,P=0.001;Z=-2.052,P=0.040).The arterial partial pressure of oxygen(PaO2)was lower in the ILD-LC group than in the LC group(Z=-5.394,P＜0.001).WBC(Z=-2.628,P=0.009),CRP(Z=-2.330,P=0.020)and ESR(Z=-2.158,P=0.031)were higher in the ILD-LC group than in the LC group.The percentage of FVC％pred(Z=-2.874,P=0.004),DLCOcSB(Z=-3.296,P=0.001)and DLCOC/VA(Z=-2.601,P=0.009)was lower in the ILD-LC groupthan in the LC group.The median survival time of the ILD-LC group was 42.0 months,with the 1-year survival rate being 79.70％,2-year survival rate being 60.80％and 5-year being 36.5％.Among the 11 patients who underwent surgery,the 1-year survival rate was 100.00％,the 2-year survival rate was 78.00％,and the 5-year survival rate was recorded at 65.00％.Multivariate Cox proportional hazards model analysis revealed that surgical treatment(HR 0.274,95％CI 0.076-0.993,P=0.034)was the independent factors influencing patients' overall survival in the ILD-LC group.During the study period,there were significantly higher mortality rates observed in the ILD-LC group(18 deaths,41.9％)compared to both the ILD group(11 deaths,13.60％)(x2=12.538,P＜0.001)and the LC group(93 deaths,27.30％)(x2=3.954,P=0.047).Conclusions Patients with ILD-LC are more likely to be elderly,male,or smokers,and their lung diffusion function is significantly impaired.The levels of tumor markers CEA,CA199,CA125,CA242,CYFRA21-1,NSE and SCC are markedly elevated compared to those in the ILD group and LC group.These patients have a poor prognosis and high mortality rates.Surgical intervention independently influences survival outcomes,and early surgery can prolong the survival of patients.