肺结核后肺癌的临床病理及实验分析

A Clinic Pathological and Experiment Analysis of Lung Cancer Patients with Previous Pulmonary Tuberculosis

目的:探讨具有肺结核病史的肺癌患者临床病理特点及结核杆菌(TB)感染状况。方法:详细询问肺癌患者临床症状、肺结核病史等,行巢式PCR(N-PCR)和间接原位PCR(IS-PCR)观察TB在肺癌患者组织和血中存在情况。结果:具有肺结核病史的肺癌大部分以体检发现,临床症状不明显,癌组织中瘢痕增多,病理类型以腺癌为主,癌组织TB检出率70.0%(7/10),明显高于无肺结核史的肺癌患者32.1%(17/53),P=0.03。TB主要位于癌组织中增生的肺泡上皮细胞、巨噬细胞胞浆内。结论:肺结核患者的慢性感染可能是继发肺癌的重要因素。

Objective:To study Clinico-pathological features and infection condition of lung can cer patients with previous pulmonary tuberculo sis(PPT).Methods:Clinic symptom and lung tu berculosis history of lung cancer patients were questioned in detail.The nested polymerase chain re action(N-PCR)technique was used to detect mycobacterium tuberculosis(TB)in the blood and tissues of lung cancers,the positive samples were confirmed and located by indirect in situ PCR(IS-PCR).Results:The lung cancer with PPT was mostly found by checking up body,the clin ic symptom was obscure,and adenocarcinoma is the main pathologic type,moreover,have more scar tissue.The lung cancer patients with PPT were detected TB in7of10,which was significantly higher than that of lung cancer patients without PPT[Fisher's Exact Test,P=0.03(2-sid ed)].TB were found mainly in plasma of alveoli epithelial cells and alveolar macrophages with-in lung can cer tissues.Conclusion:TB chronic infection could play a role in the pathogenesis of lung cancer related with PPT.