Liao Kuang-Ming, Shu Chin-Chung, Liang Fu-Wen, Chen Yi-Chen, Yu Chia-Hung, Wang Jhi-Joung, Ho Chung-Han
Department of Internal Medicine, Chi Mei Medical Center, Chiali. Tainan, Taiwan.
Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan.
J Cancer. 2023 Mar 5;14(4):657-664. doi: 10.7150/jca.81616. eCollection 2023.
: Lung cancer increases the risk for pulmonary tuberculosis (PTB). The risk factors for newly diagnosed PTB are not known in lung cancer. This study analyzed risk factors of new-onset PTB among lung cancer patients in Taiwan. : Taiwan's National Health Insurance Research Database and Taiwan Cancer Registry were used to define PTB and lung cancer patients between 2007 and 2015. Considering that mortality was a competing risk event during the cancer treatment, Fine and Gray method was performed to estimate the possible risk factors for PTB among lung cancer patients. : A total of 1,335 patients had PTB after lung cancer. The incidence of PTB increased with patients' raising age. Males had 1.7-fold (95% CI: 1.5-2.0) risk of PTB compared with females. Patients aged between 60-69 years (HR: 1.4; 95% CI: 1.1-1.8) and those ≥70 years (HR: 1.9; 95% CI: 1.5-2.4) had higher PTB risk than those aged under 50 years. Patients with history of pneumoconiosis and patients who received the treatments of surgery and chemotherapy also had significant increasing risk of PTB. : Screening for PTB may be important among lung cancer patients with the aforementioned risk factors.
肺癌会增加患肺结核(PTB)的风险。肺癌患者中新诊断出PTB的风险因素尚不清楚。本研究分析了台湾肺癌患者新发PTB的风险因素。使用台湾国民健康保险研究数据库和台湾癌症登记处来确定2007年至2015年间的PTB和肺癌患者。考虑到死亡率是癌症治疗期间的一个竞争风险事件,采用Fine和Gray方法来估计肺癌患者中PTB的可能风险因素。共有1335例患者在患肺癌后发生了PTB。PTB的发病率随患者年龄增长而增加。男性患PTB的风险是女性的1.7倍(95%置信区间:1.5 - 2.0)。60 - 69岁的患者(风险比:1.4;95%置信区间:1.1 - 1.8)和70岁及以上的患者(风险比:1.9;95%置信区间:1.5 - 2.4)患PTB的风险高于50岁以下的患者。有尘肺病病史的患者以及接受过手术和化疗治疗的患者患PTB的风险也显著增加。对于有上述风险因素的肺癌患者,筛查PTB可能很重要。