Holden H M, Quinlan J J, Hiltz J E
Can Med Assoc J. 1965 Dec 18;93(25):1306-10.
Eighty patients with carcinoma of the lung have been treated at the Nova Scotia Sanatorium since 1940; in 15, coexisting active pulmonary tuberculosis was present. No characteristic clinical or roentgenological findings indicated that the tuberculous individual also had lung cancer. In four cases cancer was not diagnosed until the lung was examined by the pathologist. In the others a considerable interval elapsed before carcinoma was suspected.Only four patients with known cancer were considered suitable for thoracotomy. In three, an attempt at curative resection was made. One survived over seven years before accidental death; one is alive less than one year after operation; the third died as a result of the surgery. Bronchogenic carcinoma should be suspected in every tuberculous patient over the age of 50; diagnostic investigations should include bronchoscopy and cytological studies of bronchial secretion and sputum. Suspicion of carcinoma in any such patient constitutes an indication for early resection of the tuberculous disease.
自1940年以来,新斯科舍疗养院已收治了80例肺癌患者;其中15例同时患有活动性肺结核。没有特征性的临床或X线表现提示结核患者同时患有肺癌。有4例直到病理学家检查肺部才诊断出癌症。其他病例在怀疑患有癌症之前经过了相当长的时间。只有4例已知患有癌症的患者被认为适合开胸手术。其中3例尝试进行根治性切除。1例在意外死亡前存活了7年多;1例术后存活不到1年;第3例死于手术。50岁以上的每一位结核患者都应怀疑患有支气管源性癌;诊断性检查应包括支气管镜检查以及支气管分泌物和痰液的细胞学研究。任何此类患者怀疑患有癌症都表明需要尽早切除结核病灶。