Clinical Analysis Of Cancer Complicated With Tuberculosis

PartⅠ: A prevalence study assessing the characteristics of pulmonary tuberculosis in patients with malignancy in HefeiObjective: To investigate the characteristics of patients with malignancy and comorbid pulmonary tuberculosis,and to lay the foundation for estimating the sample size and studying risk factors in the future research.Methods: A cross sectional study of patients with malignancy admitted to the oncology in 10 hospitals on May 24, 2013. Pulmonary tuberculosis was diagnosed by an independent expert group consisting of three specialists. Data were collected on each patient about general information, cancer type and stage.Results: Of 556 cancer patients, there were 356 male and 210 female patients. The oldest and youngest patient was 88 and 15 years old. The prevalence of malignancy and comorbid pulmonary tuberculosis was 12.72%(72 patients). The prevalence of male patients and age above 65 years old were significantly higher than that of female patients and age under 65 years old. The prevalence of advanced cancer and lymphoma were higher, despite not significantly different with other stage and type of malignancy. The constituent ratio of both lung cancer and pulmonary tuberculosis was the highest among all kinds of malignancy(33.33%).Conclusion: The prevalence of malignancy and comorbid pulmonary tuberculosis is 12.72% in this cross sectional study. The prevalence is significantly higher in male and older patients. Constituent ratio of pulmonary cancer and comorbid tuberculosis is the highest among all kinds of cancer. The stage and type of malignancy may have an influence on the prevalence.Part II: The clinical features of 229 patients with malignancy and comorbid tuberculosisObjective: To investigate the characteristics of patients with malignancy and comorbid tuberculosis.Methods: In a retrospective study, patients with malignancy and tuberculosis, admitted to the oncology from January 2008 to December 2014, were identified. Patients with only malignancy and those with only tuberculosis were selected as control group, respectively. Data were collected on each patient about general information, malignancy and tuberculosis.Results: Of 229 patients with malignancy and tuberculosis, the proportion of male patients and age above 65 years were 86.5 and 57.6% respectively. The proportion of lung cancer, squamous cell carcinoma, advanced cancer and pulmonary tuberculosis were high in patients with malignancy and tuberculosis. The new pulmonary tuberculosis was near one half. Compared with patients with only malignancy, body mass index was significantly lower and the proportion of hypoproteinemia was significantly higher in patients with malignancy and tuberculosis.Conclusion: For patients with malignancy in poor nutritional status, especially who are the elderly male and in advanced plumonary squamous cell carcinoma, cautions should be paid to the new pulmonary tuberculosis.Part III: Analysis of curative and side effects of treatment of lung cancer complicated with pulmonary tuberculosisObjective: To investigate the curative and side effects of different treatments to patients with comorbid lung cancer and tuberculosis.Methods: In a retrospective study, patients with comorbid lung cancer and tuberculosis, admitted to the oncology from January 2008 to December 2014, were identified and divided into group of simultaneous anti‐cancer and anti‐tuberculosis and only anti‐cancer group. Patients with only lung cancer were selected as control group. Data were collected on each patient about general information, prognosis and side effects.Results: Compared with only anti‐cancer group, side effects were not significantly increased; there was a trend of increasing treatment efficiency and median survival time in group of simultaneous anti‐cancer and anti‐tuberculosis. Compared with only lung cancer group, the proportion of completing treatment was lower, the improvement of Karnofsky performance status was lower and Median survival time was shorter in group of only anti‐cancer patients.Conclusion: To patients with comorbid lung cancer and tuberculosis, anti‐tumor anti‐ tuberculosis treatment can be carried out at the same time, increase the therapeutic effect, and does not increase the side effects. Hence, anti‐tuberculois treatment should be simultaneously provided with anti‐cancer therapy to patients with comorbid lung cancer and tuberculosis.