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目的分析肺结核合并肺癌的临床表现、X线特征、荧光PCR定量、病理特征、结核抗体、血CEA等特点,以期早日发现、识别肺结核合并肺癌患者。方法对南阳市第六人民医院2005年1月至2012年12月确诊的42例肺结核合并肺癌患者的临床表现、X线表现、肺癌与肺结核病灶关系、病理类型、荧光PCR定量、结核抗体、血CEA特点进行回顾性分析。结果肺结核合并肺癌多见咳嗽、痰中带血,病灶以上叶居多,肺结核与肺癌同侧较多,病理类型以鳞癌为主,荧光PCR定量阳性率和结核抗体阳性率较高,达48%,血CEA阳性率为56%,腺癌可达75%。差异有临床意义。结论明确诊断的肺结核有并发肺癌的可能,肺癌患者治疗时不能忽视肺结核,两者合并时有一定的临床特征和X线特点,应及早诊断并同时治疗,提高肺结核合并肺癌的诊断率及患者的存活率。
Objective To analyze the clinical manifestations, X-ray features, quantitative PCR, pathological features, tuberculosis antibody and blood CEA of pulmonary tuberculosis complicated with lung cancer so as to detect and identify tuberculosis patients with lung cancer as soon as possible. Methods The clinical manifestations, X-ray findings, the relationship between lung cancer and pulmonary tuberculosis, pathological types, quantitative PCR, TB antibody, blood of 42 patients with pulmonary tuberculosis confirmed by the Sixth People’s Hospital of Nanyang from January 2005 to December 2012 were retrospectively analyzed. CEA features for retrospective analysis. Results Pulmonary tuberculosis complicated with lung cancer, cough with sputum, bloody sputum, mostly above the lesion, tuberculosis and lung cancer more ipsilateral, the main pathological type squamous cell carcinoma, fluorescence quantitative PCR positive rate and TB positive rate was 48% , Blood CEA positive rate was 56%, adenocarcinoma up to 75%. Differences have clinical significance. Conclusion The diagnosis of pulmonary tuberculosis complicated with lung cancer may be possible. Patients with lung cancer can not ignore tuberculosis when treated. Both of them have certain clinical characteristics and X-ray features. They should be diagnosed and treated simultaneously to improve the diagnosis rate of pulmonary tuberculosis combined with lung cancer and the patients’ Survival rate.