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肺癌合并肺结核的研究进展:一项叙述性综述

Research progress on lung cancer complicated with pulmonary tuberculosis: a narrative review.

作者信息

Zhou Ze-Jun, Xie Hai-Yan, Bertolaccini Luca, Xia Ning, Zhang Yu

机构信息

Department of Respiratory Medicine, Nanjing Chest Hospital, The Affiliated Brain Hospital of Nanjing Medical University, Nanjing, China.

Department of Thoracic Surgery, IEO, European Institute of Oncology IRCCS, Milan, Italy.

出版信息

Transl Lung Cancer Res. 2025 Jun 30;14(6):2272-2280. doi: 10.21037/tlcr-2025-450. Epub 2025 Jun 24.

Abstract

BACKGROUND AND OBJECTIVE

Pulmonary tuberculosis (PTB) and lung cancer (LC) are both serious health threats and have a complex relationship. Research has shown that tuberculosis (TB) may induce LC through chronic inflammation. TB infection is also more common in LC patients than in the general population. Patients with LC and TB have a higher rate of misdiagnosis, missed diagnosis, and a worse prognosis. Thus, the diagnosis and treatment of patients with LC and TB are highly challenging. This narrative review aims to provide some information for clarification on the relationship between LC and TB.

METHODS

We searched for retrospective cohort studies, observational studies, systematic reviews, and meta-analyses published between the database's inception and 2024 to retrieve relevant articles on TB and LC from the PubMed/MEDLINE database.

KEY CONTENT AND FINDINGS

We outline the latest research on the relationship between pulmonary TB and LC, potential biological mechanisms, as well as the co-treatment of TB and the tumor.

CONCLUSIONS

Chronic inflammatory stimulation, scar formation, DNA damage, immune dysfunction, and other mechanisms caused by TB are associated with the development and progression of LC. LC may also reactivate TB. Currently, there is no standard diagnosis and treatment plan for co-existent TB and LC. The fundamental principle of patient management is to balance anti-tumor and anti-TB treatments based on the patient's physical condition and make comprehensive intervention decisions.

摘要

背景与目的

肺结核(PTB)和肺癌(LC)都是严重的健康威胁,且二者关系复杂。研究表明,结核病(TB)可能通过慢性炎症诱发肺癌。在肺癌患者中,结核感染也比普通人群更为常见。肺癌合并结核病患者的误诊、漏诊率更高,预后更差。因此,肺癌合并结核病患者的诊断和治疗极具挑战性。本叙述性综述旨在为阐明肺癌与结核病之间的关系提供一些信息。

方法

我们检索了从数据库建立至2024年期间发表的回顾性队列研究、观察性研究、系统评价和荟萃分析,以从PubMed/MEDLINE数据库中检索有关结核病和肺癌的相关文章。

关键内容与发现

我们概述了关于肺结核与肺癌之间关系、潜在生物学机制以及结核病与肿瘤联合治疗的最新研究。

结论

结核病引起的慢性炎症刺激、瘢痕形成、DNA损伤、免疫功能障碍等机制与肺癌的发生发展相关。肺癌也可能使结核病复发。目前,对于并存结核病和肺癌尚无标准的诊断和治疗方案。患者管理的基本原则是根据患者身体状况平衡抗肿瘤和抗结核治疗,并做出综合干预决策。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3d68/12261255/b74526f2ef0d/tlcr-14-06-2272-f1.jpg

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