摘要肺癌是全球病死率最高的恶性肿瘤,外科手术是早期肺癌的主要治疗手段.特发性肺纤维化(IPF)是一种局限于肺部的慢性进行性疾病,具有起病隐匿、进行性恶化的特征.研究结果显示,IPF与肺癌的发病机制类似,IPF患者的肺癌患病率为一般人群的3.34倍.肺癌合并IPF患者行肺切除术后短期IPF急性加重的发生率和病死率明显高于单纯肺癌患者,术后远期总体生存也较单纯肺癌患者更差.肺叶切除术仍是治疗该类患者的标准术式,但对于术前评估近、远期预后高风险的患者,应酌情采取亚肺叶切除术.术后IPF急性加重的预防和治疗有待进一步研究.

abstractsLung cancer is the leading cause of death in malignant tumors. Surgery is one of the main treatments for early stage lung cancer. Idiopathic pulmonary fibrosis (IPF), one of the most common interstitial lung disease, is a chronic, progressive lung disease, characterized by insidious onset and progressive deterioration. It is reported that there are common pathways in idiopathic pulmonary fibrosis and lung cancer, and patients with IPF have a higher risk of lung cancer than the general population, whose prevalence was 3.34 times than that of the general population. The incidence of acute exacerbations of IPF and postoperative mortality was significantly higher in lung cancer patients complicated with IPF than those without IPF. The long-term outcomes of patients with IPF are dramatically worse than those without IPF. It was concluded that lobectomy has been still the standard surgical procedure for such patients, but sublobectomy should be taken as potential alternative choice for patients with high risk after preoperative evaluation. Moreover, further studies should be conducted on the prevention and treatment of acute exacerbation of IPF after surgery.