伴随的自身免疫性风湿病 (ARD) 会增加肺癌患者的发病率并使治疗决策复杂化。我们评估了患有或不患有 ARD 的肺癌患者的诊断时的肿瘤特征和临床结果。这项回顾性队列研究包括 10 963 名在约翰·霍普金斯大学接受治疗的肺癌患者。包括肿瘤特征和结果在内的临床数据是从癌症登记处提取的。从电子病历中提取了患者 20 次 ARD 病史的数据。使用逻辑回归来比较患有和不患有ARD的患者之间的肿瘤特征；采用 Kaplan-Meier 曲线和 Cox 比例风险模型来比较生存结果。3.6% 的患者 (n=454) 存在 ARD。患有和不患有 ARD 的患者诊断时的平均年龄分别为 69 岁 (SD 10) 和 68 岁 (SD 12) (p=0.02)。女性性别和吸烟史与ARD病史显着相关（OR：1.75，OR：1.46，p<0.05）。在控制性别、种族和组织学的情况下，ARD 患者更有可能被诊断为 1 期肺癌（36.8% vs 26.9%，p<0.001）且肿瘤尺寸较小（OR：0.76，p=0.01）。值得注意的是，患有 ARD 的肺癌患者的中位总生存期 (OS) 显着延长（7.11 年 vs 1.7 年，p<0.001），与分期无关。与同行相比，患有 ARD 和肺癌的患者具有更好的 OS，与癌症无关分期和治疗，诊断时患晚期肺癌的可能性较小。需要进行更多研究来调查患有和不患有 ARD 的患者的差异免疫学抗肿瘤免疫活性和基因组变异。© 作者（或其雇主）2023。CC BY 允许重复使用。由英国医学杂志出版。

Concomitant autoimmune rheumatic diseases (ARD) can add morbidity and complicate treatment decisions for patients with lung cancer. We evaluated the tumour characteristics at diagnosis and clinical outcomes in lung cancer patients with or without ARD.This retrospective cohort study included 10 963 patients with lung cancer, treated at Johns Hopkins. Clinical data including tumour characteristics and outcomes were extracted from the cancer registry. Data on patients' history of 20 ARD were extracted from the electronic medical record. Logistic regression was used to compare tumour characteristics between those with and without ARD; Kaplan-Meier curves and Cox proportional hazards models were performed to compare survival outcomes.ARD was present in 3.6% of patients (n=454). The mean age at diagnosis was 69 (SD 10) and 68 (SD 12) in patients with and without ARD (p=0.02). Female sex and smoking history were significantly associated with a history of ARD (OR: 1.75, OR: 1.46, p<0.05). Patients with ARD were more likely to be diagnosed with stage 1 lung cancer (36.8% vs 26.9%, p<0.001) and with smaller tumour size (OR: 0.76, p=0.01), controlling for sex, race and histology. Notably, lung cancer patients with ARD had a significantly prolonged median overall survival (OS) (7.11 years vs 1.7 years, p<0.001), independent of stage.Patients with ARD and lung cancer had better OS compared with their counterparts, independent of cancer stage and treatments and were less likely to have advanced stage lung cancer at diagnosis. Additional studies are needed to investigate the differential immunological anti-tumour immune activity and genomic variations in patients with and without ARD.© Author(s) (or their employer(s)) 2023. Re-use permitted under CC BY. Published by BMJ.