Chen Y M, Chao J Y, Tsai C M, Lee P Y, Perng R P
Chest Department, Veterans General Hospital-Taipei, National Yang-Ming University, Taiwan.
Jpn J Clin Oncol. 1996 Oct;26(5):322-7. doi: 10.1093/oxfordjournals.jjco.a023240.
It has been reported that the incidence of lung cancer is higher in patients with pulmonary tuberculosis (TB). However, there is little information on the survival and clinical characteristics of these patients. We retrospectively reviewed the medical records of patients with coexisting pulmonary TB and lung cancer covering a period from 1988 to 1994. There were 31 such patients among a total of 3928 lung cancers diagnosed. Lung cancer patients had an increased risk of active pulmonary TB in comparison with the general population in Taiwan. Diabetes mellitus (DM) was found in 37.5% of patients who were diagnosed as having active pulmonary TB within 2 years before, or concurrent with, the diagnosis of lung cancer. However, none of the patients who had developed lung cancer before TB had a history of DM. Epidermoid carcinoma accounted for 64.5% of these cases. The patients who had developed active pulmonary TB before, or concurrently with, the diagnosis of lung cancer survived shorter than those who did not have pulmonary TB at diagnosis of lung cancer (P=0.007). Survival from diagnosis of pulmonary TB was longer in patients who developed the disease earlier than lung cancer (P=0.046). Survival from the time of diagnosis of lung cancer was significantly longer in patients who developed cancer earlier than active pulmonary TB (P=0.0048), those without DM (P=0.0132), those with an early tumor stage (P=0.002), and those given specific cancer treatment (P=0.0001). It is concluded that survival is shorter in lung cancer patients who present initially with active TB than in those who do not have TB.
据报道，肺结核（TB）患者的肺癌发病率较高。然而，关于这些患者的生存情况和临床特征的信息却很少。我们回顾性分析了1988年至1994年期间合并肺结核和肺癌患者的病历。在总共3928例确诊的肺癌患者中，有31例此类患者。与台湾普通人群相比，肺癌患者患活动性肺结核的风险增加。在肺癌诊断前2年内或诊断时被诊断为患有活动性肺结核的患者中，37.5%患有糖尿病（DM）。然而，在肺结核之前患肺癌的患者中，无一例有糖尿病病史。这些病例中，鳞状细胞癌占64.5%。在肺癌诊断前或诊断时已患活动性肺结核的患者，其生存期比肺癌诊断时无肺结核的患者短（P = 0.007）。肺结核发病早于肺癌的患者，其从肺结核诊断开始的生存期更长（P = 0.046）。癌症发病早于活动性肺结核的患者、无糖尿病的患者、肿瘤分期较早的患者以及接受特定癌症治疗的患者，从肺癌诊断时起的生存期显著更长（P = 0.0048、P = 0.0132、P = 0.002、P = 0.0001）。结论是，最初表现为活动性肺结核的肺癌患者的生存期比无肺结核的患者短。
