[Cooccurrence of pulmonary tuberculosis and carcinoma: diagnosis and the prognostic factors for surgical effects].

Objective: To study the association, clinical diagnosis and treatment of the coexistence of lung cancer and tuberculosis.

Methods: Sixty-five patients with coexistence of lung cancer and tuberculosis underwent surgical treatment in our hospital between 1954.1 and 2004.3. Twelve factors possibly influencing the survival were selected. A multivariate analysis of these individual variables was performed using the cumulative survival rate by the computer' COX proportional hazard model.

Results: Histologically, there were 41 cases of squamous cell carcinoma, 15 adenocarcinoma, 3 small cell carcinoma and 6 mixed carcinoma. Chest radiological study showed infiltrative tuberculosis in 41, military tuberculosis in 2, and chronic fibrocavitary tuberculosis in 22 cases. Of these, wedge excision was performed in 4, lobectomy in 38, bilobectomy in 4, pneumonectomy in 17 and palliative resection in 2 patients. There was no operative mortality. Follow-up showed that 1-, 3- and 5-year survival was 67.7% (44/65), 35.4% (23/65), and 23.1% (15/65) respectively. Clinical analysis showed that the major significant prognostic factors influencing survival were malignancy occurred in local tuberculosis, the operation procedures for lung cancer, and the stage of lung cancer (P < 0.01).

Conclusions: The occurrence of lung cancer is highly correlated to the site of tuberculosis. The recognize of this can facilitate the early diagnosis and resection of malignancy as well as the initiation of regular medical therapy.