Study On Risk Of Cancer Patients With TB Infection

Background and Objective:Tuberculosis is caused by Mycobaterium tuberculosis infection,and it is also the oldest disease that harm for our health.All around the world,tuberculosis has the highest morbidity with singleness pathogen.Phthisis is the most common disease,and one third can violate other organ such as bone tuberculosis,,spinal tuberculosis,tuberculosis of kidney,scrofula and laryngophthisis.The infection source of tuberculosis is sputum droplets of tuberculosis patients that spread by air.From 1985 to 1995, there are 1 billion people died of tuberculosis infection.There are 2-3 million people died of tuberculosis every year,and one third of people be infected with tuberculosis as well.Our country is among the 22 countries that with high burden of tuberculosis infection, every year there are 100000-150000 people die of tuberculosis,and the number of the infected rankly only second to India.Cancer is a public health problem in our country and also in the world.The number of people who died of cancer take up one of the fourth points of all the cause of death.Cancer patients has a low immunity because of the using of antineplastic agent and immunosuppressor which will cause the lack of neutrophils and damage our humoral immunity and cellular immunity after the illness.So it is a chance that with bacterial,fungus and tuberculosis infection.We do this research with 5 kinds of experimental methods.Take screen of 396 cancer patients and 80 healthy patients,and then take comparison of results of above.To explore if cancer patients are the high risk group of tuberculosis infection.Grouping the cancer patients by the kind of tumor,then to explore if the kind of tumor can do impact on the result.Methods:The subjects of in this study are 396 patients with cancer.They were under treatment in oncology department and digestive department of Chengdu Army General Hospital.Among them,there are 96 lung cancer,102 liver cancer,40 esophagus cancer,58 gastric cancer,24 p Ca,11 bladder cancer,29 cervical cancer,18 nasopharyngeal carcinoma,2 laryngocarcinoma, 16 ovarian cancer.The 396 patients were made a definite diagnosis according to past medicinal history,clinical symptoms,sign and imageological examination.Take 80 healthy people from healthy examination center as control group.We take L-J sputum culture,polymerase chain reaction(PCR),antibody Ig G to Mycobacterium tuberculosis(TB-Ab), T-SPOT.TB assay and SRID to have the sample checked.Result:Totally 396 cancer patients were submitted with a total positive rate of 12.1%(48/396)in L-J sputum culture,42.7%(169/396)in polymerase chain reaction(PCR),38.9%(154/396)in TB-Ab,44.9%(178/396)in T-SPOT.TB assay and 10.4%(41/396)in ATM.In 80 healthy persons, only PCR、TB-Ab and T-SPOT.TB assay were submitted with positive rate of 8.7%(7/80)、6.3%(5/80)and 27.5%(22/80) respectively.There were significant differences of positive rate in the two groups(P<0.01).Divide 396 patients into respiratory system group,digestive system group and urogenital system by diseased region. Respiratory system group have a positive rate of 11.4%( 13/114) in L-J sputum culture51.8%( 59/114) in polymerase chain reaction(PCR),41.2%(47/114)in TB-Ab,49.1%(56/114)in T-SPOT.TB assay and 11.4%(13/114)in SRID.Digestive system group have a positive rate of 9.5%(19/200)in L-J sputum culture35.5%(71/200)in polymerase chain reaction(PCR),38.0%(76/200)in TB-Ab,39.0%(78/200)in T-SPOT.TB assay and 9.0%(18/200)in SRID. Urogenital system group have a positive rate of 18.6%(16/86)in L-J sputum culture45.3%(39/89)in polymerase chain reaction(PCR),36.0(31/86)in TB-Ab51.2%(44/89)in T-SPOT.TB assay and 11.6%(10/89)in SRID.Dived 396 cancer patients into two groups,one is liver cancer group and the other is cancer except liver cancer.Liver cancer group have a positive rate of 6.9%(7/102)in L-J sputum culture31.4%(32/102)in polymerase chain reaction(PCR),32.4%(33/102)in TB-Ab,38.2%(39/102)in T-SPOT.TB assay and 6.9%(7/102)in SRID.The other group have a positive rate of13.9%(41/294)in L-J sputum culture46.6137/294)in polymerase chain reaction(PCR),41.2%(121/294)in TB-Ab,47.3%(139/294)in T-SPOT.TB assay and 11.6%(34/294)in SRID.Dived 396 cancer patients into two groups,one is lung cancer group,and the other is patients except lung cancer.Lung cancer group have a positive rate of 16.7%(16/96)in L-J sputum culture49.0%( 47/96) in polymerase chain reaction(PCR),44.8%( 43/96) in TB-Ab,53.1%(51/96)in T-SPOT.TB assay and 9.7%(29/96)in SRID.The other group have a positive rate of 10.7%(32/300)in L-J sputum culture40.7(122/300)in polymerase chain reaction(PCR),37.0%(111/300)in TB-Ab,42.3%(127/300)in T-SPOT.TB assay and 9.7%(29/300)in SRID.There are no significant differences of positive rate.lable the liver cancer patients and the lung cancer patients alone,the positive rate of the liver cancer is lower than that of others and the positive rate of the lung cancer is higher than that of others.Conclusion:1.Cancer patients are the high risk group of TB infection because of their poor immunity.2.There are no significant differences of positive rate between respiratory system group,digestive system group and urogenital system.3.Lung cancer patients have a higher risk of TB infection,and liver cancer patients have a lower risk because of the different treatment methods.4.So we should take early measures to have tuberculosis screening and monitor some related indicators.