Kurasawa T, Takahashi M, Kuze F, Amitani R, Murayama T, Suzuki K, Kubo Y, Niimi A, Ikeda N, Nakatani K
Chest Disease Research Institute, Kyoto University, Japan.
Kekkaku. 1992 Feb;67(2):119-25.
Twenty-two patients were diagnosed as coexisting active pulmonary tuberculosis and lung cancer during last ten years until 1989. They were nineteen men and three women and their age ranged from 61 to 84 years with a mean age of 71.3. Six patients had history of tuberculosis, three had undergone gastrectomy and four patients were complicated with diabetes mellitus. Histological types of lung cancer were epidermoid cell carcinoma in 13, adenocarcinoma in 3, large cell carcinoma in 2, and small cell carcinoma in 4 and clinical stages were "stage I" in 2, "stage II" in 2, "stage IIIA" in 5, "stage IIIB" in 4 and "stage IV" in 7, except 2 patients after surgical treatment. Localizations of lesions of cancer and tuberculosis were in the same lobes in 6, in ipsilateral lung in 6, and in contralateral lung in 6, except 4 cases, whose lesion of tuberculosis was not detectable roentgenologically and all cancers of "same lobe" cases were peripheral origins. Although, the prognosis was poor, which reflects the prognosis of lung cancer as a whole, the efficacy of anti-tuberculous chemotherapy was as good as patients without lung cancer. We mainly discussed the diagnostic points to detect the coexistence of lung cancer and pulmonary tuberculosis at early stage.
在截至1989年的过去十年间,有22例患者被诊断为同时患有活动性肺结核和肺癌。他们中有19名男性和3名女性,年龄在61岁至84岁之间,平均年龄为71.3岁。6例患者有结核病史,3例接受过胃切除术,4例合并糖尿病。肺癌的组织学类型为鳞状细胞癌13例,腺癌3例,大细胞癌2例,小细胞癌4例;临床分期为“Ⅰ期”2例,“Ⅱ期”2例,“ⅢA期”5例,“ⅢB期”4例,“Ⅳ期”7例(另有2例为手术后患者)。除4例结核病灶在X线片上未显示外,癌症和结核病灶位于同一叶的有6例,位于同侧肺的有6例,位于对侧肺的有6例,且所有“同一叶”病例中的癌症均起源于外周。尽管预后较差,这反映了肺癌总体的预后情况,但抗结核化疗的疗效与无肺癌患者相同。我们主要讨论了早期检测肺癌与肺结核并存的诊断要点。