间质性肺病合并肺癌：匹配的病例对照与队列分析

Lung cancer in interstitial lung disease: a matched case-control and cohort analysis.

期刊: ERJ Open Research
PMID: 42519221
原文: PubMed ↗
发布日期: 2026-07-28

作者

Megan Harrison — Faculty of Medicine, University of Sydney, Sydney, Australia.
Vidya Navaratnam — Department of Respiratory Medicine, Sir Charles Gairdner Hospital, Perth, Australia.
Francesca Gonnelli — Faculty of Medicine, University of Nottingham, Nottingham, UK.
Caitlin Fermoyle — Faculty of Medicine, University of Sydney, Sydney, Australia.
David Price — Observational and Pragmatic Research Institute, Singapore, Singapore.
Richard Hubbard — Faculty of Medicine, University of Nottingham, Nottingham, UK.
Tamera J Corte — Faculty of Medicine, University of Sydney, Sydney, Australia.

作者单位

Faculty of Medicine, University of Sydney, Sydney, Australia.
Department of Respiratory Medicine, Sir Charles Gairdner Hospital, Perth, Australia.
Faculty of Medicine, University of Nottingham, Nottingham, UK.
Observational and Pragmatic Research Institute, Singapore, Singapore.

摘要

中文

特发性肺纤维化（IPF）患者中肺癌的发病率显著高于普通人群。这种风险是否同样存在于其他纤维化性间质性肺病（ILD）,如过敏性肺炎（HP）和结缔组织病相关 ILD（CTD-ILD）,目前尚不明确。本研究旨在分析不同类型 ILD 中肺癌的患病率和发病率。我们使用 Optimum Patient Care Research Database 进行匹配的病例对照和队列分析。将新发 ILD 的成年患者按年龄、性别和医疗机构以最多 1:4 的比例与对照匹配。既往肺癌采用条件 logistic 回归分析。肺癌发病率采用 Fine-Gray 竞争风险模型分析。分析按总体及 ILD 亚型分别进行。共评估了 15777 例 ILD 患者（10030 例 IPF、4347 例 CTD-ILD、1400 例 HP）和 62417 例对照。索引日时 ILD 组肺癌患病率为 1.3%,对照组为 0.4%（OR 2.68, 95% CI 2.21–3.23）。随访（中位 3.0 年,四分位间距 1.3–5.4）期间,540 例（3.5%）ILD 病例和 790 例（1.3%）对照新发肺癌。ILD 组发病率为每 10 万人年 963.43,对照组为 367.57,亚分布风险比（sHR）为 1.93（95% CI 1.72–2.17）。IPF（sHR 2.36, 95% CI 2.08–2.69）和 CTD-ILD（sHR 1.78, 95% CI 1.48–2.14）患者的肺癌风险升高,而 HP 患者未见升高。该结果在不吸烟者中保持一致。ILD 与肺癌之间存在强关联,CTD-ILD 和 IPF 患者肺癌风险高于普通人群。本研究结果支持在 ILD 管理框架内考虑有针对性的肺癌监测策略。

English

Lung cancer is significantly more common in patients with idiopathic pulmonary fibrosis (IPF) than the general population. Whether this risk extends to other fibrotic interstitial lung diseases (ILDs) including hypersensitivity pneumonitis (HP) and connective-tissue disease ILD (CTD-ILD), remains uncertain. We aimed to characterise lung cancer prevalence and incidence across ILDs. We conducted matched case-control and cohort analyses using the Optimum Patient Care Research Database. Adults with incident ILD were matched up to 1:4 to controls by age, sex and practice. Pre-existing lung cancer was examined using conditional logistic regression. Lung cancer incidence rates were analysed using Fine-Gray competing-risk models. Analyses were conducted overall and by ILD subtype. We evaluated 15 777 people with ILD (10 030 IPF, 4347 CTD-ILD, 1400 HP) and 62 417 controls. Prevalence of lung cancer at index date was 1.3% in ILD versus 0.4% in controls (OR 2.68, 95% CI 2.21-3.23). During follow-up (median 3.0 years, interquartile range 1.3-5.4), 540 (3.5%) ILD cases and 790 (1.3%) controls developed lung cancer. The incidence rate was 963.43 in ILD versus 367.57 in controls per 100 000 person-years with a sub-distributional hazard ratio (sHR) of 1.93 (95% CI 1.72-2.17). Lung cancer risk was elevated in cases with IPF (sHR 2.36, 95% CI 2.08-2.69) and CTD-ILD (sHR 1.78, 95% CI 1.48-2.14) but not HP. Findings were consistent in never-smokers. A strong relationship between ILD and lung cancer exists, with increased risk in CTD-ILD and IPF compared to the general population. Findings of this study support consideration of targeted lung cancer surveillance within ILD management paradigms.

分类与指标

研究类型: 临床研究
病种: 肺癌
JCR 分区: Q1
影响因子: 4.4
新锐分区: 3区