ObjectiveTo systematically investigate the clinical characteristics, risk factors, and prognostic determinants of lung cancer (LC) in patients with combined pulmonary fibrosis and emphysema (CPFE). MethodsA total of 180 CPFE patients admitted to West China Hospital of Sichuan University between December 2010 and December 2022 were collected in this retrospective study to explore the risk factors and prognosis of patients complicated with lung cancer. ResultsCPFE-LC predominantly occurs in elderly male smokers, with squamous cell carcinoma (33.33%) and adenocarcinoma (35.29%) being the most prevalent histological subtypes. Compared with CPFE patients, those with CPFE-LC demonstrated significantly higher proportions of males, current or former smokers, smoking index values, lymphocyte counts, neutrophil-to-lymphocyte ratios, serum albumin levels, fibrinogen levels, FEV1%pred, and VC%pred. However, logistic regression analysis identified only male (OR=19.92, 95%CI 2.83-140.27) and elevated fibrinogen levels (OR=2.09, 95%CI 1.47-2.97) as independent risk factors for lung cancer development in CPFE patients. CPFE-LC patients exhibited significantly shorter survival than CPFE patients (1.67 years vs. 4.92 years, P<0.05). Kaplan-Meier survival analysis revealed no significant difference in survival among CPFE-LC patients with different histological subtypes (squamous cell carcinoma vs. adenocarcinoma vs. others, P>0.05). ConclusionsMale and fibrinogen levels are independent risk factors for lung cancer development in patients with CPFE. Patients with CPFE-LC exhibited significantly shortened survival and poor prognosis. This unfavorable prognosis is closely associated with nutritional status, advanced tumor stage, metastasis status, and treatment modalities, but shows no significant association with histopathological type.
