分析特发性肺纤维化合并肺癌(idiopathic pulmonary fibrosis-lung cancer, IPF-LC)患者的病理类型及临床特征，IPF-LC的保护及危险因素。

选择2014年11月至2022年10月我院收治的IPF患者190例，根据患者是否合并肺癌，分为单纯IPF组144例，IPF-LC组46例。收集两组临床资料、血气分析、影像学检查、血沉(erythrocyte sedimentation rate, ESR)、C反应蛋白(C reactive protein, CRP)水平。

单纯IPF组144例中，男95例(65.97%)，女49例(34.03%)，平均年龄(58.10±11.57)岁；IPF-LC组46例中，男41例(89.13%)，女5例(10.87%)，平均年龄(63.91±10.12)岁，两组性别和年龄比较差异具有统计学意义(P<0.05)。单纯IPF组平均吸烟指数250年支，IPF-LC组平均吸烟指数700年支，差异具有统计学意义(P<0.05)；单纯IPF组与IPF-LC组比较，咯血、胸痛、体重下降及杵状指差异有统计学意义(P<0.05)；IPF-LC组中结节团块影分布上叶13例(28.26%)、下叶24例(52.17%)、外周37例(80.43%)。两组动脉血氧分压(alveolar oxygen partial pressure, PaO₂)、CRP、ESR水平具有统计学差异(P<0.05)；PaO₂降低是IPF患者合并LC的危险因素(P<0.05)。

65岁以上吸烟指数高的男性IPF患者易合并LC；IPF-LC组较单纯IPF组易出现杵状指、咯血、胸痛、体重下降；IPF-LC组CRP、ESR水平高于单纯IPF组，提示慢性炎症介质在IPF-LC的发病过程中发挥作用。IPF-LC的影像学检查发现肿块常发生于纤维化明显区域，肺外周及下叶多见；PaO₂是IPF-LC的保护因素。

To analyze the pathological types and clinical characteristics of idiopathic pulmonary fibrosis-lung cancer (IPF-LC) patients, the protection and risk factors of IPF-LC.

From November 2014 to October 2022, 190 IPF patients admitted to our hospital were divided into simple IPF group (n=144) and IPF-LC group (n=46) according to whether the patients were complicated with lung cancer. The clinical data, blood gas analysis, imaging examination, erythrocyte sedimentation rate (ESR) and C reactive protein (CRP) levels of the two groups were collected.

Among the 144 cases in the simple IPF group, there were 95 males (65.97%) and 49 females (34.03), with an average age of (58.10±11.57) years; among the 46 cases in the IPF-LC group, there were 41 males (89.13%) and 5 females (10.87%), with an average age of (63.91±10.12) years, with a statistically significant difference in gender and age between the two groups (P<0.05). The average smoking index of the simple IPF group was 250 years, and the average smoking index of the IPF-LC group was 700 years, with a statistically significant difference (P<0.05); there were statistically significant differences in hemoptysis, chest pain, weight loss and clubbing between the simple IPF group and the IPF-LC group (P<0.05); in the IPF-LC group, there were 13 cases (28.26%) of nodular mass shadows in the upper lobe, 24 cases (52.17%) in the lower lobe, and 37 cases (80.43%) in the periphery. There were statistically significant differences in arterial oxygen partial pressure (PaO₂), CRP and ESR levels between the two groups (P<0.05); decreased PaO₂ was a risk factor for IPF patients with LC (P<0.05).

Male IPF patients over 65 years old with high smoking index are more likely to be complicated with LC; The IPF-LC group is more likely to have clubbing, hemoptysis, chest pain, and weight loss than the IPF group alone; the levels of CRP and ESR in the IPF-LC group are higher than those in the IPF group alone, suggesting that chronic inflammatory mediators play a role in the pathogenesis of IPF-LC; the imaging examination of IPF-LC shows that the masses often occur in the area of obvious fibrosis, peripheral lung and lower lobe; PaO₂ is a protective factor for IPF-LC.