慢性阻塞性肺疾病与肺癌：共病机制及综合管理策略

Chronic obstructive pulmonary disease and lung cancer: mechanisms of comorbidity and comprehensive management strategies

摘要:

慢性阻塞性肺疾病（COPD）与肺癌作为全球高发病率和高病死率的呼吸系统疾病，存在显著的共病关联。COPD患者罹患肺癌的风险较普通人群显著升高，而两者在致病因素、免疫微环境、表观遗传学及微生物组等方面存在复杂的交互作用。COPD患者的慢性炎症与氧化应激通过重塑免疫微环境促进肺癌发生、发展，同时影响肺癌筛查、诊断与预后。COPD合并肺癌患者在接受免疫检查点抑制剂治疗时有更好的治疗效果，这突显了免疫治疗在这一患者群体中的潜力。理解COPD与肺癌之间的复杂联系对于开发有效的诊断和治疗策略、改善患者预后至关重要。

Abstract:

Chronic obstructive pulmonary disease (COPD) and lung cancer (LC), as prevalent respiratory disorders with high global morbidity and mortality rates, exhibit a significant comorbid association. Patients with COPD have a significantly higher risk of developing LC compared to the general population, and there are complex interactions between the two diseases in terms of etiological factors, immune microenvironment, epigenetics, and the microbiome. Chronic inflammation and oxidative stress in COPD patients promote the occurrence and progression of LC by remodeling the immune microenvironment, which concurrently affects LC screening, diagnosis, and prognosis. Patients with COPD and LC show enhanced therapeutic responses to immune checkpoint inhibitors, highlighting the significant potential of immunotherapy in this patient population. Elucidating the complex interplay between COPD and LC is critical for developing effective diagnostic approaches, optimizing therapeutic strategies, and ultimately improving clinical outcomes for affected individuals.