CAJ | 학술논문

目的：探讨肺结核并发肺癌的临床表现、影像学及试验检测指标特点，提供临床诊断依据。方法回顾性分析50例肺结核并发肺癌患者的临床资料、影像学资料结果及PPD试验、血清抗结核抗体、血清腺苷脱氨酶等试验检测指标，并与同期单纯肺结核患者54例、单纯肺癌患者46例进行临床对比分析。结果临床特征比较：肺结核并发肺癌组相比于单纯肺结核组，主要表现为咳嗽、胸痛及血性胸腔积液，发热较少（P＜0．05）；相比于单纯肺癌组，主要表现为盗汗，气喘、胸痛较少（P＜0．05）。影像学特征比较：肺结核并发肺癌组相比于单纯肺结核组，肿块、毛刺状结节的比例较高，空洞、斑状片影的比例较低（P＜0．05）；相比于单纯肺癌组，肿块、弥散性结节、斑状片影的比例较低（P＜0．05）。试验检测指标比较：肺结核并发肺癌组相比于单纯肺结核组，PPD试验、血癌胚抗原检测结果比较差异具有统计学意义（P＜0．05）；相比于单纯肺癌组，血清腺苷脱氨酶检测结果具有统计学意义（P＜0．05）。结论临床表现、影像学特征及试验检测指标上的差异，对于肺结核并发肺癌的临床诊断具有一定的指导意义，临床上除常规的检查外，需尽可能完善其它检查手段，进行综合诊断，避免误诊或漏诊。
목적：탐토폐결핵병발폐암적림상표현、영상학급시험검측지표특점，제공림상진단의거。방법회고성분석50례폐결핵병발폐암환자적림상자료、영상학자료결과급PPD시험、혈청항결핵항체、혈청선감탈안매등시험검측지표，병여동기단순폐결핵환자54례、단순폐암환자46례진행림상대비분석。결과림상특정비교：폐결핵병발폐암조상비우단순폐결핵조，주요표현위해수、흉통급혈성흉강적액，발열교소（P＜0．05）；상비우단순폐암조，주요표현위도한，기천、흉통교소（P＜0．05）。영상학특정비교：폐결핵병발폐암조상비우단순폐결핵조，종괴、모자상결절적비례교고，공동、반상편영적비례교저（P＜0．05）；상비우단순폐암조，종괴、미산성결절、반상편영적비례교저（P＜0．05）。시험검측지표비교：폐결핵병발폐암조상비우단순폐결핵조，PPD시험、혈암배항원검측결과비교차이구유통계학의의（P＜0．05）；상비우단순폐암조，혈청선감탈안매검측결과구유통계학의의（P＜0．05）。결론림상표현、영상학특정급시험검측지표상적차이，대우폐결핵병발폐암적림상진단구유일정적지도의의，림상상제상규적검사외，수진가능완선기타검사수단，진행종합진단，피면오진혹루진。
Objective To investigate the clinical features ,imaging and test indexes of pulmonary tuberculosis complicat-ed with lung cancer ,and provide the basis for clinical diagnosis .Methods A retrospective analysis of clinical data of 50 cases of pulmonary tuberculosis complicated with lung cancer were conducted ,including image data results and PPD test ,serum anti myco-bacterium tuberculosis antibody and serum adenosine deaminase test indicators ,and 54 cases of simple pulmonary tuberculosis pa-tients at the same period and 46 cases of pure single lung cancer patients were compared .Results In terms of clinical features:pulmonary tuberculosis complicated with lung cancer group compared with the simple pulmonary tuberculosis group ,were mainly manifested as cough,chest pain and bloody pleural effusion,fever was less (P<0.05).Compared to the simple lung cancer group,which were mainly night sweats,shortness of breath,chest pain was less (P<0.05).The neuroimaging features:pulmonary tuberculosis complicated with lung cancer group compared to the simple pulmonary tuberculosis group ,had a higher proportion of mass,burr nodular,empty,patchy shadows in the proportion was lower (P<0.05).Compared to the simple lung cancer group ,the proportion of mass,diffusion nodular,mottled shadows lower (P<0.05).In the test indicators:pulmonary tuberculosis complicat-ed with lung cancer group compared with the simple pulmonary tuberculosis group ,PPD test,carcinoembryonic antigen detection results had statistical significant difference (P<0.05).Compared to the simple lung cancer group ,serum adenosine deaminase detection results had statistical significance (P<0.05).Conclusion Clinical manifestations,imaging characteristics and test in-dicators differences for pulmonary tuberculosis complicated with lung cancer diagnosis has certain guiding significance ,except for clinical routine inspection ,as well as other means of inspection ,comprehensive diagnosis can avoid misdiagnosis or missed diagno-sis.