吸烟相关的肺间质性疾病
2009/07/30
目的：和吸烟有关的肺疾病从慢阻肺到肺癌是一组复杂原因的肺疾病，间质性肺炎只和吸烟有关，和吸烟有关的间质性肺炎包括：呼吸性细支气管炎、脱屑性间质性肺炎、肺的朗格汉斯细胞增多症。吸烟和这些疾病的相关性研究大部分建立在流行病学的证据上。尽管在不同的几种疾病的都有不同的和独立的发病因素，这实际上包含了一系列的临床的、放射学的和病理学的特征，但是这些疾病都容易发生在吸烟的个体身上。
结论：评价组织学特征、尤其是外科肺组织活检，在区别肺组织的疾病中有重要的作用。然而，即使通过这些组织学检查，有时候也很难区别清楚疾病的实质。区分清楚疾病的实质对于临床治疗是十分重要的。进一步的实验证明，包括遗传信息在内的信息，对于提高我们对这些疾病的了解有重要的意义。
结论：评价组织学特征、尤其是外科肺组织活检，在区别肺组织的疾病中有重要的作用。然而，即使通过这些组织学检查，有时候也很难区别清楚疾病的实质。区分清楚疾病的实质对于临床治疗是十分重要的。进一步的实验证明，包括遗传信息在内的信息，对于提高我们对这些疾病的了解有重要的意义。
（孙力超编译 刘国梁审校）
Ann Diagn Pathol. 2008 Dec;12(6):445-457
Smoking-related interstitial lung disease.
Rao RN, Goodman LR, Tomashefski JF Jr.
Department of Pathology, Medical College of Wisconsin, Milwaukee, WI 53226, USA. arao@mcw.edu
Ann Diagn Pathol. 2008 Dec;12(6):445-57.
Pulmonary diseases associated with tobacco smoking are a complex group of disorders ranging from chronic obstructive pulmonary disease (COPD) to lung cancer. Interstitial lung diseases (ILDs) have only recently been linked to smoking. The ILDs related to smoking include respiratory bronchiolitis-associated interstitial lung disease, desquamative interstitial pneumonia, and pulmonary Langerhans cell histiocytosis. The relationship of smoking with each of these entities has been largely established on the weight of epidemiologic evidence. Although they have been retained as distinct and separate conditions in various classifications of interstitial lung diseases, these 3 entities share a number of clinical, radiologic, and pathologic features suggesting that they represent a spectrum of patterns of interstitial lung disease occurring in predisposed individuals who smoke. Evaluation of histologic features, particularly in surgical lung biopsy samples, is important in making the distinction between these disorders. However, even after tissue biopsy, it may sometimes be difficult to clearly separate these entities. The importance of making the distinction between them lies in the different clinical management strategies used. Further experimental evidence, including genetic information, may be important in improving our understanding of these diseases.
PMID: 18995211 [PubMed - indexed for MEDLINE]
