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肺癌治疗对非结核分枝杆菌肺病影响的分析

Analysis of the impact of lung cancer treatment on nontuberculous mycobacterial lung diseases.

作者信息

Tsuji Taisuke, Tsuyuguchi Kazunari, Tachibana Kazunobu, Kimura Yohei, Kobayashi Takehiko, Minomo Shojiro, Atagi Shinji, Matsumura Akihide, Hayashi Seiji, Suzuki Katsuhiro

机构信息

Department of Internal Medicine, National Hospital Organization Kinki-Chuo Chest Medical Center, Japan.

Clinical Research Center, National Hospital Organization Kinki-Chuo Chest Medical Center, Japan.

出版信息

Respir Investig. 2017 Jan;55(1):45-50. doi: 10.1016/j.resinv.2016.08.002. Epub 2016 Sep 19.

Abstract

BACKGROUND

Although nontuberculous mycobacteria (NTM) lung diseases can occur in association with lung cancer, no study has evaluated the effect of lung cancer treatment on NTM lung diseases. Therefore, the present study aimed to retrospectively examine the effect of lung cancer treatment on NTM lung diseases.

METHODS

Patients diagnosed with NTM lung diseases in combination with cytologically or histologically proven lung cancer between January 1, 2010 and October 31, 2014 were enroled. The clinical history of eligible patients was retrospectively reviewed.

RESULTS

Seven hundred twenty-eight patients were diagnosed with NTM lung diseases. Among these patients, 29 (3.9%) also had lung cancer. Of the 29 patients with NTM and lung cancer, 62% had Mycobacterium avium complex as the pathogenic organism. The most common lung cancer histology was adenocarcinoma (62.1%). Anti-cancer cytotoxic chemotherapy was administered to seven patients, and the two patients who did not receive NTM treatment showed worsening of their NTM lung disease.

CONCLUSION

Whether NTM lung disease should be treated during anti-cancer chemotherapy has not been not clarified by this study. Induction of anti-NTM therapy should be made after careful consideration, because the duration of anti-NTM treatment is long and anti-mycobacterial drugs have extensive effects on anti-cancer drugs. However, we think that anti-NTM therapy should be introduced after consideration of the worsening of symptoms and radiological findings associated with NTM lung disease.

摘要

背景

尽管非结核分枝杆菌(NTM)肺病可与肺癌同时发生,但尚无研究评估肺癌治疗对NTM肺病的影响。因此,本研究旨在回顾性研究肺癌治疗对NTM肺病的影响。

方法

纳入2010年1月1日至2014年10月31日期间诊断为NTM肺病合并经细胞学或组织学证实的肺癌患者。对符合条件患者的临床病史进行回顾性分析。

结果

728例患者被诊断为NTM肺病。其中,29例(3.9%)同时患有肺癌。在这29例NTM合并肺癌患者中,62%的致病微生物为鸟分枝杆菌复合群。最常见的肺癌组织学类型是腺癌(62.1%)。7例患者接受了抗癌细胞毒性化疗,2例未接受NTM治疗的患者NTM肺病病情恶化。

结论

本研究尚未阐明在抗癌化疗期间是否应治疗NTM肺病。应谨慎考虑开始抗NTM治疗,因为抗NTM治疗疗程长,且抗分枝杆菌药物对抗癌药物有广泛影响。然而,我们认为在考虑NTM肺病相关症状和影像学表现恶化后应开始抗NTM治疗。

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