Tamura Atsuhisa, Hebisawa Akira, Sagara Yuzo, Suzuki Junko, Masuda Kimihiko, Baba Motoo, Nagai Hideaki, Akagawa Shinobu, Nagayama Naohiro, Kawabe Yoshiko, Machida Kazuko, Kurashima Atsuyuki, Komatsu Hikotaro, Yotsumoto Hideki
Department of Respiratory Diseases, National Organization Tokyo Hospital, Japan.
Kekkaku. 2004 Jun;79(6):367-73.
To clarify the clinical features of the coexisting lung cancer and nontuberculous mycobacteriosis of the lung.
We analyzed clinical data on 11 admitted cases of coexisting lung cancer and pulmonary non-tuberculous mycobacteriosis at National Organization Tokyo Hospital during the period from 1997 to 2002.
There were 10 men and 1 woman, with a mean age of 66 years. Five of 11 patients had underlying pulmonary disorders, such as healed tuberculosis and lung cyst. Histological types of lung cancer were squamous cell carcinoma in 4, adenocarcinoma and small cell carcinoma in 3 each, and 8 out of 11 cases were in stages III to IV. We classified the 11 cases into 2 groups: (1) lung cancer concurrently detected with mycobacteriosis (8 cases) and (2) lung cancer sequentially detected during the follow-up of mycobacteriosis (3 cases). Lung cancers in the latter group were in relatively early stages and all patients of this group received resection of the cancer, while most of lung cancers in the concurrent group were in far-advanced, and palliative and/or supportive treatment for lung cancer were frequently selected. The strains of mycobacteria were as follows: M. avium complex (6 cases) and M. kansasii (5 cases). The incidence of lung cancer among patients with nontuberculous mycobacteriosis was 2.5 percent (2 percent of M. avium complex diseases patients and 8.2 percent of M. kansasii disease patients), while the incidence of nontuberculous mycobacteriosis in untreated lung cancer patients was 1.4 percent. Analysis of anatomical relationship between lung cancer and non-tuberculous mycobacteriosis revealed that the two diseases located in the same lung in 8 cases, and also in the same lobe in 4 out of the 8 cases. Outcome of treatment for nontuberculous mycobacteriosis was good especially in patients with M. kansasii disease, and it seemed that coexisting nontuberculous mycobacteriosis did not influence on the prognosis of lung cancer patients.
In the management of lung cancer, physicians should consider the possibility of coexisting pulmonary non-tuberculous mycobacteriosis, as well as coexisting pulmonary tuberculosis.
阐明并存肺癌与肺部非结核分枝杆菌病的临床特征。
我们分析了1997年至2002年期间东京国立医院收治的11例并存肺癌与肺部非结核分枝杆菌病患者的临床资料。
患者中男性10例，女性1例，平均年龄66岁。11例患者中有5例有肺部基础疾病，如陈旧性肺结核和肺囊肿。肺癌的组织学类型为鳞状细胞癌4例，腺癌和小细胞癌各3例，11例中有8例处于Ⅲ至Ⅳ期。我们将11例患者分为2组：（1）肺癌与分枝杆菌病同时检出（8例）；（2）在分枝杆菌病随访期间相继检出肺癌（3例）。后一组中的肺癌处于相对早期阶段，该组所有患者均接受了癌症切除术，而同时存在组中的大多数肺癌处于晚期，常选择对肺癌进行姑息和/或支持治疗。分枝杆菌菌株如下：鸟分枝杆菌复合群（6例）和堪萨斯分枝杆菌（5例）。非结核分枝杆菌病患者中肺癌的发生率为2.5%（鸟分枝杆菌复合群疾病患者为2%，堪萨斯分枝杆菌疾病患者为8.2%），而未治疗的肺癌患者中非结核分枝杆菌病的发生率为1.4%。对肺癌与非结核分枝杆菌病的解剖关系分析显示，8例患者中两种疾病位于同一侧肺，其中4例位于同一肺叶。非结核分枝杆菌病的治疗效果良好，尤其是堪萨斯分枝杆菌病患者，并存的非结核分枝杆菌病似乎不影响肺癌患者的预后。
在肺癌的治疗中，医生应考虑并存肺部非结核分枝杆菌病以及并存肺结核的可能性。
Zotero 插件