肺癌合并肺结核的临床特征分析

Clinical characteristics of lung cancer complicated with pulmonary tuberculosis

目的分析比较肺癌合并肺结核患者的临床特征。方法收集2013年1月至2016年12月第三军医大学新桥医院收治的肺癌合并肺结核患者临床资料,分别与肺结核、原发性支气管肺癌患者的人口学特征、影像学表现、病理类型、临床分期等方面进行统计学分析。结果肺癌合并肺结核患者平均年龄为(60.57±10.12)岁,男性居多(男34例,占80.95%;女8例,占19.05%),两病常发生在同部位(同部位24例,占57.14%;不同部位14例,占33.33%),影像学表现上主要以团块影(18例,占42.86%)、结节+斑片影(12例,占28.57%)为主;肺结核组以结节+斑片影为主(20例,占47.62%);原发性支气管肺癌组以团块影(31例,占64.29%)为主,三组间比较差异有统计学意义(χ~2=24.991,P<0.001)。病理分型,肺癌合并肺结核组以鳞状细胞癌(17例,占40.48%)居多,腺癌(13例,占30.95%)次之;肺癌组以腺癌(23例,占54.76%)居多,鳞状细胞癌(9例,占21.43%)次之,两组间比较差异有统计学意义(χ~2=9.990,P=0.041)。肺癌合并肺结核组及肺癌组患者临床分期均Ⅳ期为主(23例,占54.76%vs.24例,占57.14%,χ~2=1.954,P=0.745)。结论肺癌合并肺结核多见于老年男性,影像学表现多样,常混有两病的影像特征;病理类型以鳞状细胞癌居多,诊断时多为晚期。

Objective To explore and compare the clinical characteristics of lung cancer complicated with pulmonary tuberculosis. Methods The data of demography, imaging features, pathological type and clinical stage in lung cancer patients complicated with pulmonary tuberculosis, from January 2013 to December 2016 in Xinqiao Hospital, was collected to compare that with pulmonary tuberculosis and primary lung cancer patients. Results The average age of lung cancer patients complicated with pulmonary tuberculosis was 60.57±10.12 years old. Male （ n =34, 80.95%） were in major in this group, and only 8 were women. Lung cancer and pulmonary tuberculosis often occurs in the same position （ n =24, 57.14%） with only 33.33% in the different position. Besides, mass （ n =18, 42.86%）, nodules and patches （ n =12, 28.57%） were mainly imaging appearance in lung cancer complicated with pulmonary tuberculosis group, with nodules and patches （ n =20, 47.62%） mainly in pulmonary tuberculosis group and mass （ n =31, 64.29%） mainly in lung cancer group. There was significant difference between the three groups （χ 2=24.991, P 〈0.001）. Squamous cell carcinoma （ n =17, 40.48%） was the most common pathological type in lung cancer complicated with pulmonary tuberculosis group, with adenocarcinoma （ n =13, 30.95%） as the second common pathological type. While adenocarcinoma （ n =23, 54.76%） was the most common pathological type in lung cancer group, with squamous cell carcinoma （ n =9, 21.43%） as the second common pathological type. There was significant difference between the two groups （χ 2=9.990, P =0.041）. The clinical stages of lung cancer complicated with pulmonary tuberculosis and lung cancer were mainly stage Ⅳ （ n =23, 54.76% vs. n =24, 57.14%, χ 2= 1.954 , P =0.745）. Conclusion Lung cancer patients complicated with pulmonary tuberculosis were commonly the elderly men. Imaging manifestations are diverse, and mixed with two disease imaging features. Squamous cell carcinoma was the major pathological type, and most patients were in advanced stage when diagnosed.