Tamura Atsuhisa, Kawashima Masahiro, Suzuki Junko, Yamane Akira, Inoue Yuta, Fukami Takeshi, Kitani Masashi, Takahashi Fumiaki
Department of Respiratory Diseases, National Hospital Organization Tokyo National Hospital, Kiyose, Tokyo, 204-8585, Japan.
Department of Chest Surgery, National Hospital Organization Tokyo National Hospital, Kiyose, Tokyo, 204-8585, Japan.
Respir Med Case Rep. 2022 May 4;37:101664. doi: 10.1016/j.rmcr.2022.101664. eCollection 2022.
The number of cases with and lung diseases complex lung disease [MACLD are increasing globally. Lung cancer can sometimes present as a comorbidity with MACLD; however, the clinical presentation and outcomes of comorbid MACLD following lung cancer resection remain unclear. Therefore, we retrospectively assessed 17 patients with MACLD undergoing lung cancer resection to determine the impact of lung cancer surgery on comorbid MACLD. Of the 17 patients, and were present in 15 and 2 patients, respectively; 14 patients had stage I lung cancer and underwent lobectomy. Ten patients were postoperatively observed for MACLD without any further intervention, five patients underwent additional resection for conspicuous MACLD lesions, and the remaining two patients underwent complete resection for MACLD and lung cancer within the same lobe followed by rifampicin, ethambutol, and clarithromycin (RECAM) therapy. Seven patients exhibited postoperative MACLD exacerbation, six of whom developed exacerbation in the operated ipsilateral residual lobes. Six of these seven patients received RECAM, three of whom (43%) subsequently exhibited improvement. Attention should be paid to MACLD exacerbation during postoperative follow-up, especially in ipsilateral lobes. Although RECAM therapy may be beneficial in alleviating MACLD exacerbation, further investigation is warranted to validate these results.
合并有非结核分枝杆菌肺病（NTM-LD）和复杂肺部疾病（MACLD）的病例数量在全球范围内不断增加。肺癌有时可作为MACLD的合并症出现；然而，肺癌切除术后合并MACLD的临床表现和预后仍不明确。因此，我们回顾性评估了17例接受肺癌切除术的MACLD患者，以确定肺癌手术对合并MACLD的影响。17例患者中，分别有15例和2例存在NTM-LD和MACLD；14例患者为I期肺癌并接受了肺叶切除术。10例患者术后对MACLD进行观察，未进行任何进一步干预，5例患者因明显的MACLD病变接受了额外切除，其余2例患者对同一肺叶内的MACLD和肺癌进行了完整切除，随后接受利福平、乙胺丁醇和克拉霉素（RECAM）治疗。7例患者术后出现MACLD加重，其中6例在手术同侧残留肺叶出现加重。这7例患者中有6例接受了RECAM治疗，其中3例（43%）随后病情改善。术后随访时应注意MACLD加重情况，尤其是在同侧肺叶。尽管RECAM治疗可能有助于减轻MACLD加重，但仍需进一步研究以验证这些结果。
