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实体瘤患者结核病的临床特征和死亡预测因素。

Clinical profile and mortality predictors for tuberculosis disease among patients with solid tumours.

机构信息

Departamento de Moléstias Infecciosas, Hospital das Clínicas HCFMUSP, Faculdade de Medicina, Universidade de São Paulo, São Paulo, Brasil.

Serviço de Controle de Infecção Hospitalar/Infectologia - Instituto do Câncer do Estado de São Paulo (ICESP), São Paulo, Brasil.

出版信息

Infect Dis (Lond). 2022 Nov;54(11):804-809. doi: 10.1080/23744235.2022.2101690. Epub 2022 Jul 24.

Abstract

BACKGROUND

The characteristics of (MTb) disease are still obscure in patients with solid tumours, as well as the benefits of screening and treating latent tuberculosis infection (LTBI) in these patients. Our objective was to trace the clinical profile of these individuals and assess the mortality predictors related to tuberculosis (TB).

METHODS

We reviewed the medical records of 126 patients with solid tumours malignancy and who developed TB disease between January 2009 and April 2018 at a cancer referral centre.

RESULTS

The most common locations of malignancy were head and neck, with squamous cell carcinoma being the most frequent histological type, the majority (97/126) presenting locally invasive tumours (T3 or T4). A total of 120 had TB pulmonary and the microbiological diagnosis was performed in 103/126. The following variables were associated with the risk of death from TB: DPOC lung cancer, BMI, malnutrition, metastasis and ECOG 3 or 4. Previous chemotherapy treatment was a protective factor.

CONCLUSIONS

Male, usage of alcohol and smoking were the most predominant patients characteristics in our sample. In the multivariate analysis, lung cancer, presence of metastasis and ECOG ≥ 3 were associated with death from TB.

摘要

背景

在患有实体瘤的患者中,(MTb)疾病的特征仍然不清楚,以及在这些患者中筛查和治疗潜伏性结核感染(LTBI)的益处。我们的目的是追踪这些患者的临床特征,并评估与结核病(TB)相关的死亡预测因素。

方法

我们回顾了 2009 年 1 月至 2018 年 4 月在一家癌症转诊中心发生结核病的 126 名患有实体瘤恶性肿瘤的患者的病历。

结果

最常见的恶性肿瘤部位是头颈部,最常见的组织学类型是鳞状细胞癌,大多数(126/126)为局部侵袭性肿瘤(T3 或 T4)。共有 120 例患者患有肺结核,126 例患者中有 103 例进行了微生物学诊断。与结核病死亡风险相关的变量包括:COPD 肺癌、BMI、营养不良、转移和 ECOG 3 或 4。先前的化疗治疗是一个保护因素。

结论

在我们的样本中,男性、饮酒和吸烟是最主要的患者特征。在多变量分析中,肺癌、存在转移和 ECOG≥3 与结核病死亡相关。

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