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间质性肺炎伴肺癌22例临床病理分析

王顺利 薄佳琪 易祥华 朱旭友 范莉超 羌璐羽 李泊汐 陈语诺

临床与实验病理学杂志2026,Vol.42Issue(4):463-469,477,8.
临床与实验病理学杂志2026,Vol.42Issue(4):463-469,477,8.DOI:10.13315/j.cnki.cjcep.2026.04.007

间质性肺炎伴肺癌22例临床病理分析

Clinicopathological analysis of 22 cases of interstitial pneumonia associated with lung cancer

王顺利 1薄佳琪 1易祥华 2朱旭友 1范莉超 3羌璐羽 4李泊汐 4陈语诺4

作者信息

  • 1. 同济大学附属同济医院病理科,上海 200065
  • 2. 同济大学附属同济医院病理科,上海 200065||长治医学院附属和平医院病理科,长治 046000
  • 3. 同济大学附属上海市肺科医院呼吸与危重症医学科,上海 200433
  • 4. 同济大学医学院临床医学系,上海 200331
  • 折叠

摘要

Abstract

Objective To investigate the clinicopathological characteristics of patients with interstitial pneumo-nia(IP)associated with lung cancer.Methods The clinicopathological features,imaging findings,treatments,and follow-up data of 22 patients with IP associated with lung cancer were retrospectively analyzed.Protein expression was detected using the immunohistochemical EnVision two-step method.IP subtypes were classified according to the 2025 European Respiratory Society(ERS)/American Thoracic Society(ATS)classification of IP.Lung cancer diagnosis and staging followed the World Health Organization(WHO)2021 classification of thoracic tumors and the 9th edition of the TNM staging system.Results Among the 22 patients,20 were male and 2 were female,with a mean age of(61.6±6.5)years.12 patients(54.5%)had a history of smoking,and 3(13.6%)had occupational exposure.The main clinical manifestations were cough with sputum production and exertional dyspnea.High-resolution computed to-mography(HRCT)revealed that IP subtypes included usual interstitial pneumonia(UIP)in 11 cases(50.0%),non-specific interstitial pneumonia(NSIP)in 9 cases(40.9%),and lymphoid interstitial pneumonia(LIP)in 2 cases(9.1%).The predominant histological types of lung cancer were adenocarcinoma(11 cases,50.0%)and squamous cell carcinoma(8 cases,36.4%).Squamous cell carcinoma was more common in patients with a UIP pattern(6/11,54.5%),whereas adenocarcinoma predominated in those with an NSIP pattern(6/9,66.7%).TNM staging was mainly stage Ⅲ(11 cases,50.0%).Fourteen patients(63.6%)underwent surgical treatment,with a postoperative complication rate of 28.6%(4/14),including two cases of acute exacerbation of IP.Among the seven patients with follow-up data,four died within 17 months(57.1%),with a mean survival time of 8.5 months.Conclusion IP asso-ciated with lung cancer is prone to underdiagnosis or misdiagnosis both clinically and radiologically,and it is often de-tected only after surgical resection.Squamous cell carcinoma is more frequently observed in the UIP pattern,whereas adenocarcinoma is more common in the NSIP pattern.Surgical lung biopsy,tumor resection,radiotherapy,and che-motherapy may accelerate the progression of pulmonary fibrosis.

关键词

肺肿瘤/间质性肺炎/普通型间质性肺炎/非特异性间质性肺炎

Key words

lung neoplasms/interstitial pneumonia/usual interstitial pneumonia/nonspecific interstitial pneumonia

分类

医药卫生

引用本文复制引用

王顺利,薄佳琪,易祥华,朱旭友,范莉超,羌璐羽,李泊汐,陈语诺..间质性肺炎伴肺癌22例临床病理分析[J].临床与实验病理学杂志,2026,42(4):463-469,477,8.

基金项目

国家自然科学基金(82170082)、上海市科学技术委员会医学重点科技攻关专项基金(09411951600)、同济大学附属同济医院国自然培育项目(GIPY2406) National Natural Science Foundation of China(82170082) (82170082)

Shanghai Committee of Science and Technology Medical Key Science and Technology Project(09411951600) (09411951600)

National Natural Science Foundation Culti-vation Project of Tongji Hospital Affiliated to Tongji University(GIPY2406) (GIPY2406)

临床与实验病理学杂志

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