为了确定类风湿性关节炎 (RA) 中肺癌的发病率和预测因素。我们对 2001 年 4 月至 2022 年 12 月期间在我们机构诊断为 RA 的患者进行了回顾性随访研究。使用高分辨率评估肺部并发症计算机断层扫描用于 RA 诊断。对患者进行随访，直至诊断为肺癌、诊断为其他恶性肿瘤、死亡、失访或研究结束。在 771 名 RA 患者中，3.5% 被诊断为合并肺纤维化和肺气肿 (CPFE)，4.9% % 患有单纯间质性肺病 (ILD)，6.0% 患有单纯肺气肿。在随访期间（平均 9.3 年），所有患者每 1,000 名患者年的肺癌粗发病率为 2.9，CPFE 患者为 47.8，ILD 患者为 10.5，肺气肿患者为 11.9，无这些患者为 0.8并发症。与一般人群相比，男性患者的标准化发病率（95%置信区间[CI]）为2.53（1.29-3.77），女性患者为0.89（0.57-1.16）。在 Fine-Gray 回归分析中，与无肺气肿相比，CPFE 肺癌的调整后危险比 (95% CI) 为 13.48 (3.14-57.85)，单独 ILD 为 6.42 (1.42-29.09)，单独肺气肿为 4.65 (1.18-18.30)这些并发症，以及吸烟史每增加 1 包每年 1.02 (1.01-1.04)。这些因素与其他恶性肿瘤的风险无关。有吸烟史和肺部并发症的 RA 患者需要密切监测肺癌，尤其是 CPFE。© 日本风湿病学院 2024 年。牛津大学出版社出版。

To determine the incidence and predictive factors of lung cancer in rheumatoid arthritis (RA).We conducted a retrospective follow-up study of patients who were diagnosed with RA at our institution between April 2001 and December 2022. Pulmonary complications were evaluated using high-resolution computed tomography at RA diagnosis. Patients were followed until the diagnosis of lung cancer, diagnosis of other malignancies, death, loss to follow-up, or the end of the study.Among 771 RA patients, 3.5% were diagnosed with combined pulmonary fibrosis and emphysema (CPFE), 4.9% with interstitial lung disease (ILD) alone, and 6.0% with emphysema alone. During follow-up (mean of 9.3 years), the crude incidence rates of lung cancer per 1,000 patient-years were 2.9 in all patients, 47.8 in CPFE patients, 10.5 in ILD patients, 11.9 in emphysema patients, and 0.8 in patients without these complications. The standardized incidence ratios (95% confidence intervals [CI]) compared with the general population were 2.53 (1.29-3.77) for male patients and 0.89 (0.57-1.16) for female patients. In Fine-Gray regression analysis, adjusted hazard ratios (95% CI) of lung cancer were 13.48 (3.14-57.85) for CPFE, 6.42 (1.42-29.09) for ILD alone, and 4.65 (1.18-18.30) for emphysema alone versus without these complications, and 1.02 (1.01-1.04) per additional 1 pack-year for smoking history. These factors were not associated with the risk of other malignancies.Close monitoring of lung cancer is needed for RA patients with smoking history and pulmonary complications, especially CPFE.© Japan College of Rheumatology 2024. Published by Oxford University Press.