Clinical Characteristics Analysis Of 23 Cases Of Pulmonary Tuberculosis With Coexisting Lung Cancer

Objective:To analyze the clinical characteristics of pulmonary tuberculosis with coexisting lung cancer in order to summarize our experience and reduce the missed diagnosis rate of tuberculosis with coexisting lung cancer.Methods:To analyze the clinical characteristics of patients who were diagnosed as tuberculosis with coexisting lung cancer in the first affiliated hospital of Guangxi medical university from December 2011 to December 2014. We also compare the clinical characteristics such as symptoms,physical sign,laboratory examination and imaging finding between the patients who were diagnosed as tuberculosis with coexisting lung cancer and those who were without.Results:Twenty-three patients were diagnosed as tuberculosis with coexisting lung cancer in the first affiliated hospital of Guangxi medical university from December 2011 to December 2014,including twenty males and three females,the average age is 60±12,thirteen patients were smokers,the most common symptoms were cough,fever,hemoptysis,chest pain and loss of weight,of which chest pain is the most common.we analyze the serum tumor marker level of the 23 patients,of which 22 patients have elevated level.Patients who were diagnosed as tuberculosis with coexisting lung cancer with single elevated tumor marker are less than those diagnosed as tuberculosis alone(P<0.01).the rate of patients diagnosed as tuberculosis with coexisting lung cancer with multiple elevated tumor markers were 14/23, which is higher as to the tuberculosis alone patients.Among them,the level of CEA,CA125,LTA were higher for patients who were diagnosed as tuberculosis with coexisting lung cancer as to the patients who were diagnosed as pulmonary tuberculosis alone,while the level of NSE,SF were lower.the histopathology of the 23 patients who were diagnosed as tuberculosis with coexisting lung cancer patients were 17 adenocarcinoma,5 squamous carcinoma and 1 small cell lung cancer. The similarity of the chest CT features between the patients diagnosed as tuberculosis with coexisting lung cancer and patients diagnosed as pulmonary tuberculosis alone were patchy, nodular or crumb shadow,while the difference was that the patient diagnosed as tuberculosis with coexisting lung cancer can also showed mass,obstructive pneumonia,atelectasis.As to the treatment,most of the patients who were dignosed as tuberculosis with coexisting lung cancer mostly refuse to treat.We guess it may be due to the poverty and poor prognostic according to our follow-up study.Conclusion:Pulmonary tuberculosis patients who have a long history of smoking were always with coexisting lung cancer.We should raise vigilance of coexisting lung cancer if pulmonary tuberculosis patients with chest pain, hoarseness symptoms. and CEA, CA125 and non-small cell lung cancer antigen were all increase.The pathology of most pulmonary tuberculosis with coexisting lung cancer patients were adenocarcinoma. The imaging findings of pulmonary tuberculosis with coexisting lung cancer are mostly obstructive pneumonia and pulmonary atelectasis.