肺结核合并肺癌临床分析

A clinical study of pulmonary tuberculosis complicating lung cancer

目的分析肺结核合并肺癌的临床特征与影像学特点,提高肺结核合并肺癌的诊断率。方法回顾性分析118例肺结核合并肺癌患者的临床特征和影像学表现,并与同期单纯肺癌96例、单纯肺结核120例进行对照分析。结果肺结核合并肺癌组胸痛、呼吸困难少于单纯肺癌组,乏力、盗汗多于单纯肺癌组;与单纯肺结核组比较发热少于单纯肺结核组,刺激性咳嗽、持续性胸痛和血性胸水多于单纯肺结核组,有显著性差异(P<0.01)。影像上肺结核合并肺癌组斑片索条影、钙化影多于单纯肺癌组;团块影伴分叶、毛刺、小泡征并肺不张多于单纯肺结核组,小结节影,空洞、空腔影少于单纯肺结核组,有显著性差异(P<0.01)。结论临床医师在关注肺结核患者时,应警惕并发恶性变的可能,并尽早进行多种检查,以提高肺结核合并肺癌的诊断率。

Objective To analyse the clinical manifestations of pulmonary tuberculosis complicating lung cancer in order to improve its diagnostic rate. Methods To retrospectively analyse clinical data and imaging features of 118 patients suffering from pulmonary tuberculosis complicating lung cancer, and to compare all of these with simple lung cancer or tuberculosis. Results The dyspnea, chest pain were less than simple lung cancer group, and the fatigue, night sweat were more than that of the simple lung cancer group. The fever was less than simple tuberculosis, while the irritative cough, durative chest pain and plural effusion were more than the simple lung cancer group（P〈O.Ol ）. In the imaging features, there were more patches and calcification than that of the simple cancer group, and the masses with lobed, burr, bubble, atelectasis were more than the tuberculosis group, but less tree in bud, cavity, cavum than the tuberculosis group （P〈O.O1）. Conclusions Clinicians should keep in mind of the occurrence of malignancies during the follow-up of patients with tuberculosis. It is important to take many methods to improve lung cancer diagnostic rate.