Tamura A, Nagai H, Sagara Y, Kawabe Y, Akagawa S, Nagayama N, Machida K, Kurashima A, Sato K, Yotsumoto H, Mori M, Hebisawa A
Department of Respiratory Diseases, Tokyo National Chest Hospital, Japan.
Kekkaku. 1998 Nov;73(11):619-24.
To clarify features of lung cancer in patients with tuberculosis sequelae, we analyzed data on 15 cases (5.1%) who were diagnosed with lung cancer before death among 294 deceased cases with tuberculosis sequelae at our hospital. There were 12 men and 3 women, with a mean age of 64 years. Most of the 15 patients had pulmonary dysfunction, and 4 had received home oxygen therapy. All 12 men had a history of smoking, and 10 of them had squamous cell carcinoma of the lung. There was no definite correlation between the locations of the tuberculosis lesion and those of lung cancer lesion on chest X-rays. Twelve patients had had thoracoplasty for tuberculosis, and in 6 of these patients the lung cancer occurred in the same lung. Lung cancer was apt to be diagnosed in an advanced stage. However, in patients who received home oxygen therapy, diagnosis had been made at an early stage because of the frequent chest X-ray follow-up. We conclude that lung cancer is an important complication in patients with tuberculosis sequelae, and early diagnosis of lung cancer by careful follow-up is essential in the care of cases with tuberculosis sequelae who have poor pulmonary function and/or systemic conditions.
为阐明肺结核后遗症患者肺癌的特征，我们分析了我院294例肺结核后遗症死亡病例中15例（5.1%）生前被诊断为肺癌患者的数据。其中男性12例，女性3例，平均年龄64岁。15例患者中大多数有肺功能障碍，4例接受过家庭氧疗。12名男性均有吸烟史，其中10例为肺鳞状细胞癌。胸部X线片上肺结核病灶部位与肺癌病灶部位之间无明确相关性。12例患者因肺结核接受过胸廓成形术，其中6例患者的肺癌发生在同一侧肺。肺癌往往在晚期才被诊断出来。然而，在接受家庭氧疗的患者中，由于频繁的胸部X线随访，肺癌在早期就得到了诊断。我们得出结论，肺癌是肺结核后遗症患者的一种重要并发症，对于肺功能差和/或全身状况不佳的肺结核后遗症患者，通过仔细随访早期诊断肺癌至关重要。
