Libshitz H I, Pannu H K, Elting L S, Cooksley C D
Department of Diagnostic Radiology, University of Texas M. D. Anderson Cancer Center, Houston 77030, USA.
J Thorac Imaging. 1997 Jan;12(1):41-6. doi: 10.1097/00005382-199701000-00006.
The demographics of tuberculosis (TB) and the therapy of malignancies have significantly changed since the last comprehensive review of TB in cancer patients. Fifty-six patients with both TB and malignancy were identified from January 1989 through December 1994 in a population of 61,931 newly registered cancer patients. The frequency of TB in cancer patients was 90 per 100,000. TB was more frequent in foreign-born patients (p < 0.001) and in racial and ethnic minorities (p < 0.001) than in non-Hispanic whites. TB developed during therapy in 48%. TB was discovered synchronously with the malignancy in 30% and in 21% occurred > or = 18 months after therapy. Pulmonary TB occurred in 50 (89%) patients and extrapulmonary TB in nine (16%) (three had both). Chest radiographic findings did not suggest TB in 20%. TB was less frequent in lung cancer (p < 0.001), head and neck cancer (p = 0.002), and solid hematologic malignancies (p < 0.001) than it had been historically, but the frequency was unchanged in acute leukemia patients (p = 0.46). TB in cancer patients occurs at a nine times greater than in the general population. It is now most frequent in leukemia patients.
自上次对癌症患者结核病（TB）进行全面综述以来，结核病的人口统计学特征及恶性肿瘤的治疗方法已发生显著变化。1989年1月至1994年12月期间，在61931名新登记的癌症患者中，共识别出56例同时患有结核病和恶性肿瘤的患者。癌症患者中结核病的发病率为每10万人90例。外国出生的患者（p < 0.001）以及少数种族和族裔群体（p < 0.001）中的结核病发病率高于非西班牙裔白人。48%的结核病发生在治疗期间。30%的结核病与恶性肿瘤同时被发现，21%的结核病在治疗后18个月或更长时间出现。50例（89%）患者发生肺结核，9例（16%）发生肺外结核（3例两者皆有）。20%的患者胸部X线检查结果未提示结核病。与历史情况相比，肺癌（p < 0.001）、头颈癌（p = 0.002）和实体血液系统恶性肿瘤患者中的结核病发病率较低，但急性白血病患者的发病率没有变化（p = 0.46）。癌症患者中结核病的发病率是普通人群的9倍。目前白血病患者中结核病最为常见。
