摘要
目的分析肺结核合并肺癌患者的临床特征及影响患者5年生存率的因素。方法选择收治的肺结核合并肺癌患者76例的临床资料。分析患者的临床症状及影响学特征;采用Kaplan-Meier生存分析法分析患者生存率,对影响患者预后的因素进行回归分析。结果患者首发症状依次为咳嗽36例(47.4%),胸闷22例(28.9%),发热20例(26.3%),咯血咯痰18例(23.7%),胸背部疼痛17例(22.4%)。影像学和病理学检查显示肿瘤位于左肺32例(42.1%),右肺35例(46.1%),全肺9例(11.8%);中央型肺癌26例(34.2%),周围型肺癌50例(65.8%);鳞癌45例(59.2%),腺癌21例(27.6%),小细胞肺癌8例(10.5%),未定型2例(3.9%);肿瘤TNM分期Ⅰ期16例(21.1%),Ⅱ期29例(38.2%),Ⅲ期21例(27.6%),Ⅳ期10例(13.2%)。患者中位生存期为26个月,累积1年、3年、5年生存率分别为77.6%,35.5%,17.7%。单因素分析结果显示肿瘤病理类型、TNM分期和肺结核活动状态与患者预后显著相关。多因素分析结果显示:病理类型、TNM分期和肺结核活动状态是预后的独立影响因素。结论肺结核合并肺癌患者无典型的临床表现,应避免漏诊误诊。肿瘤病理类型、TNM分期和肺结核活动状态是影响预后的独立危险因素。
Objective To study the clinical characteristics of pulmonary tuberculosis patients with lung cancer and fac- tors affecting the 5-year survival rate. Methods Clinical data of 76 patients with tuberculosis and lung cancer were analyzed retrospectively. The survival rate of the patients was analyzed by Kaplan-Meier survival analysis, and the prognostic factors were analyzed by regression analysis. Results First symptoms of patients, 36 cases （47.4%） had cough, 22 cases （ 28.9% ） had chest pain, 18 cases （23.7%）had hemoptysis and sputum, and 17 cases （22.4%）had thoracodorsal pain. Imaging and pathological detection showed that 32 cases （42.1% ） of tumor were in the left lung,35 cases （46.1% ） of tumor were in the right lung, and 9 cases （11.8% ）of tumor were in the total lung, the central lung cancer （34.2%）26 cases ,the peripheral lung cancer （65.8%） 50 cases, squamous cell carcinoma in 45 cases （59.2%）, adenocarcinoma in 21 cases （27.6%）, small cell lung cancer in 8 cases （ 10.5% ） ,unformed in 2 cases （3.9%） , stage Ⅰ 16 cases （21.1%）, stage Ⅱ 29 cases （38.2%） , stage Ⅲ 21 cases （27.6%）and stageⅣ 10 cases （13.2%）. The median survival time was 26 months. 1-, 3-and 5-year survival rates were 77.6%, 35.5% and 17.7% respectively. The results of univariate analysis showed that pathological type,TNM stage and pulmonary tuberculosis activity were significantly correlated with prognosis. Multivariate analysis showed that pathological type, TNM stage and pulmonary tuberculosis activity were independent prognostic factors. Conclusion Pulmonary tuberculosis patients with lung cancer without typical clinical manifestations, should improve the diagnostic level, to avoid misdiagnosis. Pathological type, TNM stage and pulmonary tuberculosis activity are the independent prognostic risk factors.
出处
《实用癌症杂志》
2017年第4期590-592,共3页
The Practical Journal of Cancer
关键词
肺结核
肺癌
临床特征
预后
影响因素
Pulmonary tuberculosis
Lung cancer
Clinical features
Prognosis
Influencing factors
