Hu Ying, Yang Xinjie, Nie Lihui, Zhao Dan, An Jun, Li Baolan
Department of Oncology, Beijing Chest Hospital, Capital Medical University, Beijing 101149, China.
Department of Tuberculosis, Beijing Chest Hospital, Capital Medical University, Beijing 101149, China.
Zhongguo Fei Ai Za Zhi. 2020 May 20;23(5):337-342. doi: 10.3779/j.issn.1009-3419.2020.101.25. Epub 2020 Apr 27.
New treatment methods such as targeted therapy and immune checkpoint inhibitors have been applied to lung cancer patients. It is necessary to further understand the patients with lung cancer combined with pulmonary tuberculosis with the development of lung cancer research. The purpose of this study was to analyze the clinical characteristics of lung cancer patients with pulmonary tuberculosis, the status of driver genes, and their relationships.
A retrospective analysis was performed on 405 patients with lung cancer and pulmonary tuberculosis hospitalized in our hospital from January 2014 to December 2019. The relationship between clinical characteristics and driver genes status was analyzed.
Among the 405 patients with lung cancer combined with pulmonary tuberculosis, 77.3% were male and 85.3% were patients with a history of smoking. The pathological type was mainly lung adenocarcinoma. When there were cavities in chest computed tomography (CT) , squamous cell carcinoma was the main type. 214 patients underwent driver genes testing. The epidermal growth factor receptor (EGFR) gene mutation rate was 35.9%, of which 41.8% were exon 19 deletion mutations and 50.9% were exon 21 L858R mutations. When there were cavities in the chest CT, the EGFR mutation rate was significantly reduced (16.1%). The positive rate of anaplastic lymphoma kinase (ALK) fusion gene detection was 2.5%, the mutation rate of c-ros oncogene 1 receptor kinase (ROS1) gene was 1.9%, the mutation rate of V-raf murine sarcoma viral oncogene homolog B1 (BRAF) gene was 1.1%, and the mutation rate of Kirsten Rat Sarcoma Viral Oncogene Homolog (KRAS) gene was 10.1%. The genetic mutation rate of female patients with lung cancer and pulmonary tuberculosis was 50.0%, and that of men was 27.9%.
Patients with lung cancer and pulmonary tuberculosis are predominantly male with smoking history. Adenocarcinoma is the most common pathological type. The positive rate of gene mutation was not significantly different from that of simple lung cancer, but when there were cavities in the chest image, the genetic mutation rate was significantly reduced.
靶向治疗和免疫检查点抑制剂等新的治疗方法已应用于肺癌患者。随着肺癌研究的发展，有必要进一步了解合并肺结核的肺癌患者。本研究旨在分析肺癌合并肺结核患者的临床特征、驱动基因状态及其关系。
对2014年1月至2019年12月在我院住院的405例肺癌合并肺结核患者进行回顾性分析。分析临床特征与驱动基因状态之间的关系。
在405例肺癌合并肺结核患者中，男性占77.3%，有吸烟史的患者占85.3%。病理类型主要为肺腺癌。胸部计算机断层扫描（CT）有空洞时，主要类型为鳞状细胞癌。214例患者进行了驱动基因检测。表皮生长因子受体（EGFR）基因突变率为35.9%，其中19外显子缺失突变占41.8%，21外显子L858R突变占50.9%。胸部CT有空洞时，EGFR突变率显著降低（16.1%）。间变性淋巴瘤激酶（ALK）融合基因检测阳性率为2.5%，c-ros癌基因1受体激酶（ROS1）基因突变率为1.9%，V-raf鼠肉瘤病毒癌基因同源物B1（BRAF）基因突变率为1.1%， Kirsten大鼠肉瘤病毒癌基因同源物（KRAS）基因突变率为10.1%。肺癌合并肺结核女性患者基因突变率为50.0%，男性为27.9%。
肺癌合并肺结核患者以男性、有吸烟史为主。腺癌是最常见的病理类型。基因突变阳性率与单纯肺癌无显著差异，但胸部影像有空洞时，基因突变率显著降低。
