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肺结核和肺癌:同时性和先后性发生。

Pulmonary tuberculosis and lung cancer: simultaneous and sequential occurrence.

机构信息

Federal University of Rio Grande do Sul, School of Medicine, Porto Alegre, Brazil.

出版信息

J Bras Pneumol. 2013 Jun-Aug;39(4):484-9. doi: 10.1590/S1806-37132013000400013.

Abstract

OBJECTIVE

Lung cancer (LC) is the leading cause of cancer-related death and represents a major public health problem worldwide. Another major cause of morbidity and mortality, especially in developing countries, is tuberculosis. The simultaneous or sequential occurrence of pulmonary tuberculosis and LC in the same patient has been reported in various case series and case-control studies. The objective of this study was to describe the characteristics of patients developing tuberculosis and LC, either simultaneously or sequentially.

METHODS

This was a cross-sectional study based on the review of medical charts.

RESULTS

The study involved 24 patients diagnosed with tuberculosis and LC between 2009 and 2012. The diagnoses of tuberculosis and LC occurred simultaneously in 10 patients, whereas tuberculosis was diagnosed prior to LC in 14. The median time between the two diagnoses was 5 years (interquartile range: 1-30 years). Fourteen patients (58.3%) were male, 20 (83.3%) were White, and 22 (91.7%) were smokers or former smokers. The most common histological type was adenocarcinoma, identified in 14 cases (58.3%), followed by epidermoid carcinoma, identified in 6 (25.0%). Seven patients (29.2%) presented with distant metastases at diagnosis; of those 7 patients, 5 (71%) were diagnosed with LC and tuberculosis simultaneously.

CONCLUSIONS

In the present study, most of the patients with tuberculosis and LC were smokers or former smokers, and tuberculosis was diagnosed either before or simultaneously with LC. Non-small cell lung cancer, especially adenocarcinoma, was the most common histological type.

摘要

目的

肺癌(LC)是癌症相关死亡的主要原因,也是全球主要的公共卫生问题。另一个发病率和死亡率的主要原因,特别是在发展中国家,是肺结核。在各种病例系列和病例对照研究中,已经报道了同一患者同时或先后发生肺结核和 LC 的情况。本研究的目的是描述同时或先后发生肺结核和 LC 的患者的特征。

方法

这是一项基于病历回顾的横断面研究。

结果

本研究纳入了 2009 年至 2012 年间诊断为肺结核和 LC 的 24 例患者。肺结核和 LC 的诊断同时发生在 10 例患者中,而肺结核在 LC 之前诊断的有 14 例。两次诊断之间的中位时间为 5 年(四分位距:1-30 年)。14 例患者(58.3%)为男性,20 例(83.3%)为白人,22 例(91.7%)为吸烟者或曾经吸烟者。最常见的组织学类型是腺癌,有 14 例(58.3%),其次是表皮样癌,有 6 例(25.0%)。7 例患者(29.2%)在诊断时即有远处转移;这 7 例患者中,有 5 例(71%)同时诊断为 LC 和肺结核。

结论

在本研究中,大多数肺结核和 LC 患者是吸烟者或曾经吸烟者,肺结核的诊断要么在 LC 之前,要么与 LC 同时进行。非小细胞肺癌,特别是腺癌,是最常见的组织学类型。

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