Gabazza E, Taguchi O, Yamakami T, Machishi M, Ibata H, Tsutsui K, Suzuki S
Third Department of Internal Medicine, Mie University School of Medicine, Tsu-city, Japan.
Nihon Kyobu Shikkan Gakkai Zasshi. 1992 Oct;30(10):1820-4.
We evaluated the frequency and the backgrounds of lung cancer patients with obstructive pneumonitis. Among 84 cases of lung cancer, 35 presented with bronchial obstruction at bronchoscopy or on radiological studies. Of these 35 cases, 8 had infectious obstructive pneumonitis. This complication was observed more commonly in patients with squamous cell carcinoma. A comparative analysis of the immunological and nutritional states before the occurrence of bacterial complication was performed on patients with infectious obstructive pneumonitis and those with non-infectious obstructive pneumonitis. The serum concentration of total protein, albumin and total cholesterol was significantly lower in patients who subsequently developed bronchial obstruction and bacterial infection, compared to concentrations in patients with non-infectious obstructive pneumonitis. Similarly, there was significant decrease in the number of peripheral lymphocytes, and neutrophils as well as a significant reduction of the serum concentration of IgM in the group of patients with infectious complications. These results suggest that nutritional and immunological deficiencies, in association with local airway obstruction, may be determining factors in the occurrence of infectious obstructive pneumonitis in patients with lung cancer.
我们评估了患有阻塞性肺炎的肺癌患者的频率及背景情况。在84例肺癌病例中,35例在支气管镜检查或影像学研究中出现支气管阻塞。在这35例病例中,8例患有感染性阻塞性肺炎。这种并发症在鳞状细胞癌患者中更为常见。对感染性阻塞性肺炎患者和非感染性阻塞性肺炎患者在发生细菌并发症之前的免疫和营养状况进行了对比分析。与非感染性阻塞性肺炎患者的浓度相比,随后发生支气管阻塞和细菌感染的患者血清总蛋白、白蛋白和总胆固醇浓度显著降低。同样,感染性并发症患者组的外周淋巴细胞和中性粒细胞数量显著减少,血清IgM浓度也显著降低。这些结果表明,营养和免疫缺陷与局部气道阻塞相关,可能是肺癌患者发生感染性阻塞性肺炎的决定性因素。