间质性肺炎伴肺癌22例临床病理分析OA

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.