PURPOSE: The reported frequency of lung cancer in patients with Interstitial Lung Diseases (ILDs)varies greatly from study to study, ranges from 4.8% to 48.2% and a high incidence of lung Ca has been shown between patients with IIPs, ranging from 9.8% to 38% in Idiopathic Interstital Pneumonia (IIP) patients.Our aim was to study the frequency and to determine the time of appearance of lung cancer in patients with IIPs.
METHODS: In the study were included 52 patients (33male and 19 female) median age 69.94 (range 41 to 84)with various types of IIPs who were in a follow up of 51 months from January 2002 to March 2006. Patients with unclassified pulmonary fibrosis were excluded. The ATS/ERS criteria (2000)and/or lung biopsy were used to identify the type of IIP (38 IPF/UIP, 9 NSIP, 3 BOOP, 1 DIP and 1 RB-ILD. The patients have undergone lung function tests and HRCT scans every six months.
RESULTS: Five IIP patients (9.61%) seem to develop lung cancer, in four IPF (10.5%) and one f-NSIP (11.11%), in a mean time of 18.8 months (range 3 to 29 months). Two bronchoalveolar type of cancer in one NSIP and one IPF patient, and 3 Non Small Cell Lung Cancer (NSCLC)- one of squamous cell type-in IPF patients.In 2 more NSIP patients of our cohort we observed coin lesion nodules suspicious for malignancy but not confirmed yet.
CONCLUSION: Our data is consistent with other available studies, and shows that the development of lung cancer among patients with IIPs is frequent at 9.61% and IPF it is at 10.5%, and it seems to appear in a mean time of one and a half year after the diagnosis of IPF.
CLINICAL IMPLICATIONS: Clinicians should be aware of the lung cancer development in IIP patients during the progression of the disease, that could additional contribute to the poor prognosis of them.
DISCLOSURE: M. A. Dimadi, None.