关键词: 关节炎, 类风湿；肺肿瘤；免疫抑制剂

Abstract: Objective　To investigate the clinical features of rheumatoid arthritis（RA） with lung cancer，increasing clinicians' knowledge of the disease.Methods　General information，clinical manifestations，laboratory indicators，pathological types and clinical stages, treatment and prognosis of inpatients diagnosed as RA with lung cancer，who were admitted to Beijing Shijitan Hospital from January 2011 to December 2017，were retrospectively analyzed.Results　 Of the total RA inpatients treated in the hospital during the same period，the enrolled 9 cases accounted for 0.57%（9/1 561），including 4 males，and 5 females.The average age at RA diagnosis was（53.7±19.6） years （range，25-80 years），and that at lung cancer diagnosis was（73.8±10.8） years（range，58-89 years），indicating that the average interval from RA diagnosis to lung cancer diagnosis was（20.1±19.5） years（range，3-50 years）．Joint swelling and pain were found in all the cases，and joint deformity were found in 2 cases.Initial symptoms of cough and expectoration were found in 3 cases.Rheumatoid factor test was underwent in 8 cases，and 5 of them were detected with positive results.Serum CYFRA21-1 increased in 7 cases，and CEA increased in 6 cases.Adenocarcinoma was the pathological subtype in 7 cases，together with poorly differentiated squamous cell carcinoma in 2 cases.Of the 9 patients, 8 were stage ⅣA patients, and 1 had no stage.Hormone and/or immunosuppressive therapies were given to 6 cases，and chemotherapy and/or targeted therapy were given to 5 cases.8 cases were diagnosed with stage Ⅳ lung cancer，5 of them died later，other 3 had brain and thoracic metastasis despite of active treatment.Conclusion　Patients with RA and lung cancer showed high mortality and poor prognosis with adenocarcinoma as the predominate subtype.In view of this，tumor markers should be regularly monitored in RA patients，which is helpful for early detection of lung cancer and improvement of prognosis.

Key words: Arthritis, rheumatoid；Lung neoplasms；Immunosuppressive agents