Lung cancer in patients with idiopathic pulmonary fibrosis

Abstract

Idiopathic pulmonary fibrosis (IPF) was reported to be associated with increased risk of lung cancer as a result of the occurrence of atypical or dysplastic epithelial changes in fibrosis which progressed to invasive malignancy. In that situation, the cancer will develop in the area of major fibrosis. To investigate the direct relationship between fibrosis and cancer development, the real concordance rate of the two lesions in the chest computed tomography (CT) was analysed and compared to the histological types of lung cancer.The subjects included 63 patients with combined lung cancer and IPF (IPF-CA), 218 patients with lone IPF, and 2,660 patients with primary lung cancer. All patients were diagnosed at Asan Medical Center during the same period.The age, percentage of smokers, and the male sex were significantly higher in IPF-CA compared with lone IPF. The odds ratio of smoking was 2.71 compared to nonsmoking IPF controls. In IPF-CA, 56% of the cancer was located in the periphery of the lung and 52% in the upper lobe. The majority of the cancers (64%) were found in the nonfibrotic area at chest CT. The most frequent cell type was squamous cell carcinoma (35%), and there was no significant difference in the cancer cell type between IPF-CA and total lung cancer population.These findings suggest that in combined lung cancer and idiopathic pulmonary fibrosis patients, the features of the lung cancer are similar to the total lung cancer population.

Exacerbation of Idiopathic Interstitial Pneumonias Associated with Lung Cancer Therapy

“…In particular, the incidence of lung cancer in patients with idiopathic pulmonary fibrosis (IPF) is higher than in the general population, with relative risks reported to be from 7 to 14 (1)(2)(3)(4)(5). Kawasaki et al (6) reported that IPF was found in 7.5% of surgically-resected lung cancer cases.…”

Overexpression of SERPIN B3 promotes epithelial proliferation and lung fibrosis in mice

“…6 An increased incidence of carcinomas, such as squamous cell carcinoma and adenocarcinoma, mainly located in peripheral lung areas, has been reported in IPF patients. [7][8][9] Whether the appearance of abnormal epithelial cells protects or promotes fibrosis remains uncertain. 10 Several experimental and human studies reported a pro-fibrogenetic influence of metaplastic epithelial cells through the secretion of factors favoring fibrotic processes.…”

Inflammation and Pulmonary Fibrosis

“…However, the size of this study and the magnitude of increased incidence strongly suggest a positive association. Subsequent research has further defined the association with increased risk reported in male IPF patients who smoke with a similar frequency of histological cancer subtypes observed in non-IPF sufferers (Park et al, 2001) supporting historical observations (Stack et al, 1972). However, other studies have failed to confirm an association between IPF and malignancy although varying methodology, each with inherent risk of errors, means that a degree of uncertainty remains (Samet, 2000).…”