CAJ | 학술논문

目的研究肺结核与肺癌并存的CT影像特征.方法搜集经组织学、细胞学及临床综合确诊为肺结核与肺癌并存的患者104例,全部患者均有详细CT影像资料.将先有肺结核后出现肺癌或两者同期发现者定为Ⅰ组；将肺癌化疗期间出现肺结核者定为Ⅱ组；再将Ⅰ组中周围型肺癌定为Ⅰa组,Ⅱ组中周围型肺癌定为Ⅱa组,2组的中心型肺癌分别定为Ⅰb组及Ⅱb组.观察总结肺结核及肺癌病灶的影像特征,并将肺癌及肺结核出现的先后进行x2和t检验分析.结果 104例中Ⅰ组92例(88.5％),Ⅱ组12例(11.5％).Ⅰ组中肺癌与肺结核同叶者70例(76.1％),不同叶者22例(23.9％).Ⅰ、Ⅱ组之间肺结核的分布构成差异没有统计学意义(x2=4.302,P=0.507).肺结核影像表现中索条影、硬结钙化灶及病灶与胸膜粘连表现2组间比较差异有统计学意义(x2值分别为22.737、15.193、27.792,P值均＜0.05),而其他征象差异没有统计学意义(P＞0.05).中心型肺癌33例,Ⅰb组28例,Ⅱb组5例,Ⅰb中2例表现不典型,动态观察病变增大；周围型肺癌71例中,Ⅰa组64例,Ⅱa组7例.Ⅰ a组中,表现典型者39例(60.9％),不典型者25例(39.1％),以直径≥3 cm病变居多(49例,76.6％),除磨玻璃病变外所有病灶增强扫描均有强化.结论肺癌化疗期间继发肺结核的CT表现与普通活动性肺结核具有同样特征；分析肺结核合并的肺癌病灶,其形态、增强扫描及动态观察等均有助于诊断及鉴别诊断.
목적 연구폐결핵여폐암병존적CT영상특정.방법 수집경조직학、세포학급림상종합학진위폐결핵여폐암병존적환자104례,전부환자균유상세CT영상자료.장선유폐결핵후출현폐암혹량자동기발현자정위Ⅰ조；장폐암화료기간출현폐결핵자정위Ⅱ조；재장Ⅰ조중주위형폐암정위Ⅰa조,Ⅱ조중주위형폐암정위Ⅱa조,2조적중심형폐암분별정위Ⅰb조급Ⅱb조.관찰총결폐결핵급폐암병조적영상특정,병장폐암급폐결핵출현적선후진행x2화t검험분석.결과 104례중Ⅰ조92례(88.5％),Ⅱ조12례(11.5％).Ⅰ조중폐암여폐결핵동협자70례(76.1％),불동협자22례(23.9％).Ⅰ、Ⅱ조지간폐결핵적분포구성차이몰유통계학의의(x2=4.302,P=0.507).폐결핵영상표현중색조영、경결개화조급병조여흉막점련표현2조간비교차이유통계학의의(x2치분별위22.737、15.193、27.792,P치균＜0.05),이기타정상차이몰유통계학의의(P＞0.05).중심형폐암33례,Ⅰb조28례,Ⅱb조5례,Ⅰb중2례표현불전형,동태관찰병변증대；주위형폐암71례중,Ⅰa조64례,Ⅱa조7례.Ⅰ a조중,표현전형자39례(60.9％),불전형자25례(39.1％),이직경≥3 cm병변거다(49례,76.6％),제마파리병변외소유병조증강소묘균유강화.결론 폐암화료기간계발폐결핵적CT표현여보통활동성폐결핵구유동양특정；분석폐결핵합병적폐암병조,기형태、증강소묘급동태관찰등균유조우진단급감별진단.
Objective To study the CT characteristics of coexisting pulmonary tuberculosis and lung cancer.Methods One hundred and four patients of coexisting pulmonary tuberculosis and lung cancer proved by histology,cytology or clinical underwent CT examination.All patients were divided into two groups,group Ⅰ were the patients with the lung cancer after tuberculosis or both found simultaneously (group Ⅰ a with peripheral lung cancer and group Ⅰ b with central lung cancer),group Ⅱ with tuberculosis during lung cancer chemotherapy (group Ⅱ a with peripheral lung cancer and group Ⅱ b with central lung cancer).Imaging characteristics of tuberculosis and lung cancer were compared.x2 test and t test were used for the statistical analysis.Results Of 104 patients,there were 92 patients (88.5％) in group Ⅰ and 12 patients (11.5％)in group Ⅱ.Seventy patients (76.1％) of lung cancer and tuberculosis were located in the same lobe and 22 patients (23.9％) in the different lobes in group Ⅰ.There was no significant difference in distribution of tuberculosis between group Ⅰ and group Ⅱ (x2 =4.302,P =0.507).The fibrous stripes,nodules of calcification and pleural adhesion of tuberculosis were statistically significant between the two groups (x2 =22.737,15.193,27.792,P ＜0.05).There were 33 central lung cancers and 71 peripheral lung cancers.In group Ⅰ a (64 patients of peripheral lung cancers),39 patients (60.9％) had typical manifestations and most of the lesions were ≥ 3 cm(n =49,76.6％),solid lesions showed variable enhancement.Conclusions Secondary tuberculosis during lung cancer chemotherapy has the same CT characteristics with the common active tuberculosis.The morphology,enhancement pattern of lesion and follow-up are helpful for the diagnosis of lung cancer after tuberculosis.