中华医学杂志
中華醫學雜誌
중화의학잡지
National Medical Journal of China
2014年
36期
2838-2840
,共3页
结核,肺%肺肿瘤%疾病特征%预后
結覈,肺%肺腫瘤%疾病特徵%預後
결핵,폐%폐종류%질병특정%예후
Tuberculosis,pulmonary%Lung neoplasms%Disease attributes%Prognosis
目的：分析肺结核合并肺癌患者的临床特征及预后影响因素。方法对1998年1月至2005年1月青岛市胸科医院诊断为肺结核合并肺癌的58例住院及门诊患者的临床及影像学特征进行综合分析。以Kaplan-Meier法计算患者生存率；选择对预后可产生影响的9个特征性临床因素进行分析，单因素分析采用Logrank检验，多因素分析采用Cox回归模型。结果肺结核合并肺癌临床首发症状依次为咳嗽、胸闷、发热及咯血。影像学特征：肿瘤与结核病灶在同侧36例，不同侧22例。病灶形态：结节团块24例；空洞19例；浸润影8例；合并肺不张7例。病理学类型鳞癌33例，腺癌17例，小细胞癌4例，未定型4例。 TNM分期：Ⅰ期13例，Ⅱ期22例，Ⅲ期16例，Ⅳ期7例。58例患者的中位生存期为24个月，1、3、5年生存率分别65.5％、44.0％、29.0％。单因素分析显示，肺癌TNM分期（ P＝0.000）和肺结核是否活动（ P＝0.024）与患者预后显著相关。多因素分析均显示，肺癌TNM分期（RR＝2.629，95％CI：1.759～3.928，P＝0.000）和肺结核是否活动（RR＝1.885，95％CI：1.023～3.471，P＝0.042）是患者的相对独立预后因素。结论肺结核合并肺癌的临床及影像学特征有助于早期诊断、早期治疗，肺癌TNM分期和肺结核是否活动是影响患者预后的主要因素。
目的：分析肺結覈閤併肺癌患者的臨床特徵及預後影響因素。方法對1998年1月至2005年1月青島市胸科醫院診斷為肺結覈閤併肺癌的58例住院及門診患者的臨床及影像學特徵進行綜閤分析。以Kaplan-Meier法計算患者生存率；選擇對預後可產生影響的9箇特徵性臨床因素進行分析，單因素分析採用Logrank檢驗，多因素分析採用Cox迴歸模型。結果肺結覈閤併肺癌臨床首髮癥狀依次為咳嗽、胸悶、髮熱及咯血。影像學特徵：腫瘤與結覈病竈在同側36例，不同側22例。病竈形態：結節糰塊24例；空洞19例；浸潤影8例；閤併肺不張7例。病理學類型鱗癌33例，腺癌17例，小細胞癌4例，未定型4例。 TNM分期：Ⅰ期13例，Ⅱ期22例，Ⅲ期16例，Ⅳ期7例。58例患者的中位生存期為24箇月，1、3、5年生存率分彆65.5％、44.0％、29.0％。單因素分析顯示，肺癌TNM分期（ P＝0.000）和肺結覈是否活動（ P＝0.024）與患者預後顯著相關。多因素分析均顯示，肺癌TNM分期（RR＝2.629，95％CI：1.759～3.928，P＝0.000）和肺結覈是否活動（RR＝1.885，95％CI：1.023～3.471，P＝0.042）是患者的相對獨立預後因素。結論肺結覈閤併肺癌的臨床及影像學特徵有助于早期診斷、早期治療，肺癌TNM分期和肺結覈是否活動是影響患者預後的主要因素。
목적：분석폐결핵합병폐암환자적림상특정급예후영향인소。방법대1998년1월지2005년1월청도시흉과의원진단위폐결핵합병폐암적58례주원급문진환자적림상급영상학특정진행종합분석。이Kaplan-Meier법계산환자생존솔；선택대예후가산생영향적9개특정성림상인소진행분석，단인소분석채용Logrank검험，다인소분석채용Cox회귀모형。결과폐결핵합병폐암림상수발증상의차위해수、흉민、발열급각혈。영상학특정：종류여결핵병조재동측36례，불동측22례。병조형태：결절단괴24례；공동19례；침윤영8례；합병폐불장7례。병이학류형린암33례，선암17례，소세포암4례，미정형4례。 TNM분기：Ⅰ기13례，Ⅱ기22례，Ⅲ기16례，Ⅳ기7례。58례환자적중위생존기위24개월，1、3、5년생존솔분별65.5％、44.0％、29.0％。단인소분석현시，폐암TNM분기（ P＝0.000）화폐결핵시부활동（ P＝0.024）여환자예후현저상관。다인소분석균현시，폐암TNM분기（RR＝2.629，95％CI：1.759～3.928，P＝0.000）화폐결핵시부활동（RR＝1.885，95％CI：1.023～3.471，P＝0.042）시환자적상대독립예후인소。결론폐결핵합병폐암적림상급영상학특정유조우조기진단、조기치료，폐암TNM분기화폐결핵시부활동시영향환자예후적주요인소。
Objective To explore the clinical characteristics and prognostic factors of pulmonary tuberculosis with concurrent lung cancer.Methods Comprehensive analyses were conducted for 58 cases of pulmonary tuberculosis patients with lung cancer.Their clinical symptoms , signs and imaging results were analyzed between January 1998 and January 2005 at Qingdao Chest Hospital.Kaplan-Meier method was utilized to calculate their survival rates.Nine prognostic characteristics were analyzed.Single factor analysis was performed with Logrank test and multi-factor analysis with Cox regression model.Results The initial symptoms were cough , chest tightness , fever and hemoptysis.Chest radiology showed the coexistence of two diseases was 36 in the same lobe and 22 in different lobes.And there were pulmonary nodules ( n=24 ) , cavities ( n =19 ) , infiltration ( n =8 ) and atelectasis ( n =7 ).According to the pathological characteristics, there were squamous carcinoma (n=33), adenocarcinoma (n=17), small cell carcinoma (n=4) and unidentified (n=4) respectively.The TNM stages were Ⅰ(n=13),Ⅱ(n=22), Ⅲ(n=16) and Ⅳ(n=7) respectively.The median survival period was 24 months.And the 1, 3, 5-year survival rates were 65.5%, 65.5% and 29.0% respectively.Single factor analysis showed that lung cancer TNM staging ( P =0.000 ) and tuberculosis activity ( P =0.024 ) were significantly associated with patient prognosis.And multi-factor analysis showed that lung cancer TNM staging (RR=2.629, 95%CI:1.759-3.928, P=0.000) and tuberculosis activity (RR=1.885, 95%CI: 1.023 -3.471, P =0.042) were relatively independent prognostic factors.Conclusions The clinical and radiological characteristics contribute jointly to early diagnosis and therapy of tuberculosis with concurrent lung cancer.And TNM staging of lung cancer and activity of tuberculosis are major prognostic factors.
