肺癌と活動性結核の合併例の検討

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Seventeen cases of coexisting bronchogenic carcinoma and active pulmonary tuberculosis were diagnosed during the period from 1975 to 1979. The majority were male of over 60 years of age; namely, only one case was female, 12 cases were over 60 years old and 12 cases were squamous cell carcinoma. The incidence of bronchogenic carcinoma among cases with active tuberculosis was 25.8 times higher in males and 19.6 times higher in females than the corresponding figures in the general population. Observing by histological type, the proportion of squamous cell carcinoma among cases with coexisting tuberculosis was higher than that among total cases of bronchogenic carcinoma, but the difference was not statistically significant after standardization by sex and age. The -diagnosis of coexisting bronchogenic carcinoma was very difficult, and in the majory of cases, the final diagnosis as coexisting carcinoma was delayed over one year from the detection of active tuberculosis. The foci of active tuberculosis and of bronchogenic carcinoma were found mostly in the same lobe, but the coexistence of both foci in the same locality was found in only one case of squamous cell carcinoma. In the follow up study of patients with active tuberculosis, the cell-mediated immune status returned to normal level in patients who responded well to anti-tuberculosis chemotherapy, while it remained under impaired status in patients who failed to respond to chemotherapy. The patients of bronchogenic carcinoma with advanced stage showed attenuated cell-mediated immune response, and the trend was more marked among coexisting cases of carcinoma and tuberculosis. The suggested possible explanation of the coexistence of bronchogenic carcinoma and pulmonary tuberculosis is that the former is not caused by the latter, but both diseases develop as a result of attenuated nonspecific cellular immunity.
日本結核病学会の論文

肺癌と活動性結核の合併例の検討

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