Clinical characteristics of patients with lung cancer and idiopathic pulmonary fibrosis in China

Background: To identify distinguishing characteristics between patients with lung cancer and idiopathic pulmonary fibrosis (IPF-CA) and patients with IPF alone in China.

Methods: The medical records of 24 IPF-CA patients and 80 IPF patients admitted to Peking Union Medical College Hospital (PUMCH) from 1999 to 2009 were reviewed.

Results: The incidence of lung cancer in IPF patients in our study was 23.1% (24/104), and the percentage of patients who smoked in the IPF-CA group was higher than the IPF group (87.5% and 55.0%, respectively, P = 0.004). Three symptoms, including productive cough, hemoptysis, and chest pain, were more common in IPF-CA patients than IPF alone patients. There was no significant difference in the percentage of patients with other abnormal serum tumor markers, except that the percentage of patients with abnormal neuron specific enolase was significantly higher in the IPF-CA group than in the IPF group (28.6% vs. 7.4%, P = 0.041). The most common histology type was adenocarcinoma (33.3%). The median overall survival for IPF-CA patients and IPF patients was 7.0 months (95% confidential interval (CI), 2.51-11.49) and 14.0 months (95% CI, 1.26-26.74), respectively, with no significant difference (P = 0.327).

Conclusion: Due to a high proportion of IPF cases complicated with lung cancer, physicians should closely observe lung cancer incidence during the IPF follow-up period. Individualized treatment for lung cancer patients with IPF is emphasized. Hence, it is important to ensure the safety of cancer treatments.