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

摘要： 目的　总结类风湿关节炎（RA）合并肺癌的临床特点，提高临床医生对此类疾病的认识。方法　回顾性分析首都医科大学附属北京世纪坛医院2011年1月—2017年12月住院治疗的RA合并肺癌患者的一般资料、临床表现、实验室检查指标、病理分型与临床分期、治疗与预后。结果　RA合并肺癌患者9例，占同期住院RA患者的0.57%（9/1 561），其中男4例、女5例。RA确诊年龄25~80岁，平均确诊年龄（53.7±19.6）岁；肺癌确诊年龄58~89岁，平均确诊年龄（73.8±10.8）岁。RA确诊到肺癌确诊病程为3~50年，平均（20.1±19.5）年。9例患者均有关节肿痛，2例出现关节畸形；9例患者中3例以咳嗽、咳痰为肺部主要首发症状。8例患者测定类风湿因子，5例升高；9例患者中7例细胞角蛋白19片段（CYFRA21-1）升高，6例癌胚抗原（CEA）升高。9例患者中7例为腺癌，2例为低分化鳞癌。9例患者中8例为ⅣA期患者，1例无分期。9例患者中6例给予激素和/或免疫抑制剂治疗，5例给予化疗和/或靶向治疗。9例患者中8例确诊肺癌时为Ⅳ期，且8例患者中5例死亡，3例虽经积极治疗仍出现脑转移及胸椎转移。结论　RA合并肺癌患者以腺癌为主，病死率高，预后差，对RA患者应定期监测肿瘤标志物的变化，有助于早期发现肺癌，改善预后。

关键词: 关节炎, 类风湿；肺肿瘤；免疫抑制剂