title: Lung cancer in patients with combined pulmonary fibrosis and emphysema revisited with the 2015 World Health Organization classification of lung tumors.
abstract: OBJECTIVE
  Combined pulmonary fibrosis and emphysema (CPFE) is a newly defined entity that comprises upper lobe emphysema and lower lobe fibrosis. Patients with CPFE are at high risk for lung cancer and have poor prognoses. To investigate the clinical and pathological characteristics of lung cancer with CPFE, lung cancers with CPFE and non-CPFE interstitial lung disease (ILD) were reevaluated by 2015 WHO classification and compared.
  
  
  METHODS
  A total of 60 patients with histologically proven lung cancer were selected from the database of two institutional medical centers. The subjects included 35 patients with combined lung cancer and CPFE, and 25 patients with lung cancer and non-CPFE ILD. The clinical and pathological characteristics were evaluated and compared between the two groups.
  
  
  RESULTS
  CPFE group had more current smokers but relatively normal pulmonary function compared with non-CPFE group. The majority of the cancers in CPFE were located in the lower lobes (24 of 35 cases), where the pulmonary fibrosis visualized as reticular opacities was predominant. Keranitizing subtype of squamous cell carcinoma was prevalent in lung cancers with CPFE. Poor prognoses were found both for CPFE and non-CPFE group because of advanced stage.
  
  
  CONCLUSIONS
  Lung cancers with CPFE show some unique clinical characteristics, and the distinct histological subtype may have therapeutic implication.
authors: Department of Radiology, Peking University First Hospital, Beijing, 100034, China.
authors: Li
authors: L
authors: Gao
authors: Department of Radiology, China-Japan Friendship Hospital, Beijing, 100029, China.
authors: Sheng
authors: S
authors: Xie
authors: Department of Radiology, China-Japan Friendship Hospital, Beijing, 100029, China.
authors: Hui
authors: H
authors: Liu
authors: Department of Pathology, China-Japan Friendship Hospital, Beijing, 100029, China.
authors: Pingping
authors: P
authors: Liu
authors: Department of Pathology, Peking University First Hospital, Beijing, 100034, China.
authors: Yan
authors: Y
authors: Xiong
authors: Department of Pathology, China-Japan Friendship Hospital, Beijing, 100029, China.
authors: Jiping
authors: J
authors: Da
authors: Department of Pulmonology, Peking University First Hospital, Beijing, 100034, China.
authors: Chengli
authors: C
authors: Que
authors: Department of Pulmonology, China-Japan Friendship Hospital, Beijing, 100029, China.
authors: Huaping
authors: H
authors: Dai
authors: Department of Pulmonology, China-Japan Friendship Hospital, Beijing, 100029, China.
authors: Chen
authors: C
authors: Wang
mesh_terms: D017677:Age Distribution; D000368:Aged; D002289:Carcinoma, Non-Small-Cell Lung / Q000145:classification* / Q000453:epidemiology* / Q000473:pathology; D015331:Cohort Studies; D015897:Comorbidity; D016208:Databases, Factual; D005260:Female; D014943:Global Health; D006785:Hospitals, University; D006801:Humans; D008175:Lung Neoplasms / Q000145:classification* / Q000453:epidemiology* / Q000473:pathology; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D011379:Prognosis; D011656:Pulmonary Emphysema / Q000175:diagnosis / Q000453:epidemiology* / Q000628:therapy; D011658:Pulmonary Fibrosis / Q000175:diagnosis / Q000453:epidemiology* / Q000628:therapy; D012189:Retrospective Studies; D018570:Risk Assessment; D017678:Sex Distribution; D016019:Survival Analysis; D014944:World Health Organization
keywords: emphysema; interstitial lung disease; lung cancer; pathology