Assefa Muluneh, Tigabie Mitkie, Amare Azanaw, Tamir Mebratu, Setegn Abebaw, Wondmagegn Yenesew Mihret, Biset Sirak, Almagharbeh Wesam Taher, Girmay Getu
Department of Medical Microbiology, School of Biomedical and Laboratory Sciences, College of Medicine and Health Sciences, University of Gondar, Gondar 196, Ethiopia.
Department of Medical Parasitology, School of Biomedical and Laboratory Sciences, College of Medicine and Health Sciences, University of Gondar, Gondar 196, Ethiopia.
JNCI Cancer Spectr. 2025 Jul 1;9(4). doi: 10.1093/jncics/pkaf062.
Patients with cancer are at a higher risk of tuberculosis (TB) infection because of the immunosuppressive effect of prolonged chemotherapy. This study determined the prevalence of TB and TB-related deaths among patients with cancer from a global perspective.
We followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines to conduct the current study. Extracted data from relevant articles were analyzed using Stata, version 17.0, software (StataCorp LP). The effect size estimate was computed using a random-effects model, considering a 95% confidence interval (CI). The I2 statistic and Galbraith plot were used to confirm heterogeneity. A univariate meta-regression, sensitivity, and subgroup analyses were conducted to identify the source of heterogeneity. The Egger test and a funnel plot were used to check publication bias.
In the 13 articles, of the 2 135 402 patients with malignancy, 31 073 had TB. The pooled estimate of TB was 3.69% (95% CI = 1.79% to 5.58%), with high heterogeneity (I2 = 99.99%). The pooled TB prevalence in Europe was 7.04 (95% CI = 1.09% to 12.99%). The prevalence of TB in a single study in North America was 8.78% (95% CI = 8.45% to 9.10%). A higher TB prevalence was observed in patients with solid tumors (6.84%, 95% CI = 4.30% to 9.38%), followed by hematologic malignancies and solid tumors (3.63%, 95% CI = 1.46% to 5.80%). Pulmonary and extrapulmonary TB were 3.05% and 0.77%, respectively. The rate of TB-related death was 0.04%. In meta-regression, publication year and sample size did not affect heterogeneity.
There is a considerable burden of TB (3.69%) in patients with cancer, which calls for routine TB screening and early treatment of cases to reduce complications.
由于长期化疗的免疫抑制作用，癌症患者感染结核病（TB）的风险更高。本研究从全球视角确定了癌症患者中结核病的患病率及与结核病相关的死亡情况。
我们遵循系统评价和Meta分析的首选报告项目指南开展本研究。使用Stata 17.0软件（StataCorp LP）对从相关文章中提取的数据进行分析。采用随机效应模型计算效应量估计值，并考虑95%置信区间（CI）。使用I²统计量和Galbraith图来确认异质性。进行单变量Meta回归、敏感性分析和亚组分析以确定异质性来源。使用Egger检验和漏斗图检查发表偏倚。
在这13篇文章中，2135402例恶性肿瘤患者中有31073例患有结核病。结核病的合并估计患病率为3.69%（95%CI = 1.79%至5.58%），异质性较高（I² = 99.99%）。欧洲的结核病合并患病率为7.04%（95%CI = 1.09%至12.99%）。北美一项研究中的结核病患病率为8.78%（95%CI = 8.45%至9.10%）。实体瘤患者的结核病患病率较高（6.84%，95%CI = 4.30%至9.38%），其次是血液系统恶性肿瘤和实体瘤（3.63%，95%CI = 1.46%至5.80%）。肺结核和肺外结核的患病率分别为3.05%和0.77%。与结核病相关的死亡率为0.04%。在Meta回归中，发表年份和样本量不影响异质性。
癌症患者中结核病负担相当大（3.69%），这就需要进行常规结核病筛查并对病例进行早期治疗以减少并发症。
