肺结核合并肺癌的危险因素及预后研究

Study on Risk Factors and Prognosis of Pulmonary Tuberculosis Complicated with Lung Cancer

目的探究分析肺结核合并肺癌的危险因素及预后研究。方法研究筛选2016年1月至2017年12月本人诊疗的肺结核合并肺癌患者37例作为观察对象,对其临床病历资料进行回顾性分析,对影响患者预后效果的危险因素进行分析。结果本组37例患者CT检查显示:肺不张2例、分叶毛刺状12例、单纯块影17例、单侧胸腔积液3例、不规则偏心空洞3例。X线片检查显示:肺癌病灶与肺结核病灶分布于同侧不同叶11例、同侧同叶18例、不同侧8例;结核病灶分布于三个肺叶6例、分布于2个肺叶12例、分布于1个肺叶19例。单因素Logistic回归分析,明显消瘦、刺激性咳嗽、有分叶毛刺、肺不张、咯血、常年吸烟等是影响肺结核合并肺癌的危险因素。肺不张、明显消瘦、肿块有分叶毛刺、常年吸烟等是影响肺结核合并肺癌的独立危险因素;COX回归模型分析,肿瘤TNM分期、原结核灶处恶变、手术方式等是影响预后结果的危险因素。结论临床中,对于肺结核合并肺癌存在较高漏诊率;而肺不张、肺块有分叶毛刺、明显消瘦、刺激性咳嗽及常年吸烟等均是影响肺结核合并肺癌的危险因素。

Objective To explore the risk factors and prognosis of pulmonary tuberculosis complicated with lung cancer. Methods A total of 37 pulmonary tuberculosis patients with lung cancer who were treated in our hospital from January 2016 to December 2017 were screened. The clinical data of these patients were analyzed retrospectively, and the risk factors affecting the prognosis of patients were analyzed. Results The CT examination of 37 patients in this group showed that 2 cases of atelectasis, 12 cases of lobular burr, 17 cases of simple block shadow, 3 unilateral pleural effusion and 3 irregular eccentric cavity. X-ray examination showed that the lesions of lung cancer and pulmonary tuberculosis were distributed on the same side, 11 cases of different lobe, 18 cases of ipsilateral lobes and 8 cases of different sides. The lesions of tuberculosis were distributed in three lung lobes, 6 cases, 2 cases of pulmonary lobes, 12 cases and 1 cases of 19 cases of lung lobe. Obliteration, marked weight loss, segmental burr, and perennial smoking are independent risk factors affecting pulmonary tuberculosis and lung cancer; analysis of COX regression models, tumor TNM staging, malignancy at primary tuberculosis sites, and surgical methods are risks that affect prognosis outcomes. Conclusion In clinic, there is a high rate of missed diagnosis for pulmonary tuberculosis combined with lung cancer, and lung atelectasis, segmental burr in lung mass, marked weight loss, irritating cough and perennial smoking are risk factors affecting pulmonary tuberculosis and lung cancer.