老年肺结核合并肺癌临床病理分析

CLINICAL PATHOLOGICAL ANALYSIS OF THE AGED WITH TUBERCULOSIS COEXISTED WITH LUNG CANCER

目的 探讨老年肺结核与肺癌并存的可能机制及趋势.警惕两病并存.方法 通过30例老年患者的临床症状,X线胸片表现,痰结核菌及痰脱落细胞检查.根据28例经手术病理证实,2例痰结核菌和痰癌细胞同时阳性确诊结果分析.结果 2例痰结核菌和痰癌细胞同时阳性未作手术治疗,28例手术患者27例大体标本及镜检均见肺癌与干酪坏死性结核灶或结节灶并发于同一部位、同一肺或同一肺段.结论 60岁以上老年肺癌与肺结核并存者有上升趋势.积极作痰结核菌及痰脱落细胞检查,必要时行纤支镜或CT检查.警惕老年患者肺癌与肺结核并存的可能性.

Objetive To explore the possible mechanism and tendency of coexistence of lung cancer and tuberculosis in the aged, and to be on alert to their coexistence. Methods Through observing their clinical symp-toms , taking X - ray films and examining tubercle bacillus and cancer cells in sputum, 30 aged cases were exam-ined . Results No surgical treatment was given to the 2 cases who were positive for both tubercle bacilli and cancer cells in sputum. In 27 out of 28 postoperative cases, lung cancer was found coexisted with tubercular cheesy necrot-ic focus in the same lobe or segment. Conclusions There is an increasing tendency of the coexistence of lung can-cer and tuberculosis in people aged 60 and over. Regular examination for tubercle bacillus and shedding cells in sputum is suggested, and also fiberoptic bronchoscope and CT examination if necessary. It should be alert to the possible coexistence of lung cancer and tuberculosis in aged patients.