T�bek�loz Tan�s� ile Takip Edilen Hastalarda Primer Akci�er Kanseri Geli�me Oran� ve Hastalar�n Klinik �zellikleri

K�m�rc�o�lu, Berna; Ay�k T�rk, Merve; Evkan �zt�rk, Aysen; Polat, Gulru

Cilt : 37 Say� : 3 Y�l : 2023

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T�bek�loz Tan�s� ile Takip Edilen Hastalarda Primer Akci�er Kanseri Geli�me Oran� ve Hastalar�n Klinik �zellikleri [G��s Hastanesi Dergisi]

G��s Hastanesi Dergisi. 2021; 35(3): 149-154 | DOI: 10.5222/IGH.2021.84429

T�bek�loz Tan�s� ile Takip Edilen Hastalarda Primer Akci�er Kanseri Geli�me Oran� ve Hastalar�n Klinik �zellikleri

Berna K�m�rc�o�lu¹, Merve Ay�k T�rk², Aysen Evkan �zt�rk¹, Gulru Polat¹
¹Sa�l�k Bilimleri �niversitesi Doktor Suat Seren G��s Hastal�klar� ve Cerrahisi E�itim Ara�t�rma Hastanesi, G��s Hastal�klar� Ana Bilim Dal�, �zmir, T�rkiye
²Sa�l�k Bilimleri �niversitesi �zmir Bozyaka E�itim Ara�t�rma Hastanesi, G��s Hastal�klar� Ana Bilim Dal�, �zmir, T�rkiye

Giri�:
Akci�er kanseri ve t�berk�loz (TB) d�nya �zerinde �nde gelen mortalite ve morbidite nedenleridir. �ki hastal��n birlikteli�inde sigara i�imi, altta yatan di�er komorbid hastal�klar gibi multifakt�riyel etkilenme s�z konusu olup yeterli kan�t toplanamam��t�r. �ki �nemli halk sa�l�� problemi olan bu iki hastal��n birbiri ile ili�kisinin g�sterilmesi hem t�berk�loz tedavisine hem de kanser tarama program� ve karsinogenez mekanizmas�na katk� sa�layacakt�r.
Gere�-Y�ntem:
01.01.2013-31.12.2016 tarihleri aras�nda TB servisinde yatarak izlenen 1004 aktif akci�er t�berk�lozu tan�l� hasta retrospektif incelenmi� ve TB tan�s� ile izlenen hastalardan sito/histopatolojik olarak akci�er kanseri tan�s� alan 39 hasta �al��mada incelenmi�tir.
Bulgular:
�al��mam�zda t�m vakalar�n (n=1004) 39�unda (%3,88) TB akci�er kanseri birlikteli�i saptanm��t�r. Hastalar�n b�y�k bir k�sm� squam�z h�creli (n=23, % %58,9) olup tan� an�nda evre III-IV (n=34, %87,1) hastalardan olu�maktayd�. Akci�er kanseri tan�s� alan hastalar�n �o�unlu�unda sigara i�me �yk�s� mevcuttu (n=25, %64,1). T�m evrelerde medyan sa�kal�m 8,94 (%95 Cl, 3,91-13,97) ay iken evre I ve II�de 8,94 ay, Evre III�de 7,89 ay, Evre IV�de ise 3,58 ayd� (p=0,381). Hastalar�m�zdan 37�sinde( %94,8) �l�m g�r�l�rken 2 (%5,12) hastan�n takibi devam etmektedir.
Sonu�:
�al��mam�zda TB ile akci�er kanseri birlikteli�i ara�t�r�lm�� ve �o�unlukla squam�z sitolojinin hakim oldu�u g�r�lm��t�r. TB klinik ve radyolojik olarak akci�er kanserini maskeleyip, akci�er kanseri tan�s�nda gecikmeye, hastalar�n ileri evrede tan� almas�na ve tedavide gecikmelere neden olabilir. TB tan�s�yla takip edilen hastalarda spesifik tedaviye ra�men tedavisinin etkisiz olmas� akla akci�er kanseri tan�s�n� getirmeli ve hastalar bu y�nde takip edilmelidir.

Anahtar Kelimeler: Akci�er Kanseri, T�berk�loz, Karsinogenez

Primary Lung Cancer Development Rate in Patients Followed Up with a Diagnosis of Tuberculosis and Clinical Characteristics of the Patients

Berna K�m�rc�o�lu¹, Merve Ay�k T�rk², Aysen Evkan �zt�rk¹, Gulru Polat¹
¹Department of Chest Disease, Doctor Suat Seren Chest Diseases and Thoracic Surgery Education and Research Hospital, Izmir, Turkey
²Department of Pulmonology, Health Siences University �zmir Bozyaka Training and Research Hospital, �zmir, Turkey

Aim and Objectives: Lung cancer and tuberculosis (TB) are the leading causes of mortality and morbidity worldwide. In the coexistence of the two diseases, there is a multifactorial effect such as smoking and other underlying comorbid diseases, and sufficient evidence has not been collected. Demonstrating the relationship between these two diseases, which are two important public health problems, will contribute to both the treatment of tuberculosis, the cancer screening program and the mechanism of carcinogenesis.
Metarial and methods: Between 01.01.2013 and 31.12.2016, 1004 patients diagnosed with active pulmonary tuberculosis who were hospitalized in the TB service were analyzed retrospectively and 39 patients who were diagnosed with TB and diagnosed with lung cancer cytologically/histopathologically were examined in the study.
Results: In our study, TB lung cancer coexistence was found in 39 (3.88%) of all cases (n=1004). Most of the patients had squamous cells (n=23, 58.9%) and consisted of stage III-IV (n=34, 87.1%) patients at the time of diagnosis. Most of the patients diagnosed with lung cancer had a history of smoking (n=25, 64.1%). Median survival in all stages was 8.94 (95% CI, 3.91-13.97) months, compared to 8.94 months in stages I and II, 7.89 months in stage III, and 3.58 months in stage IV. month (p=0.381). While death was observed in 37 (94.8%) of our patients, the follow-up of 2 (5.12%) patients continues.
Conclusion: In our study, the coexistence of TB and lung cancer was investigated and mostly squamous cytology was found to be dominant. TB can mask lung cancer clinically and radiologically, causing delay in the diagnosis of lung cancer, diagnosis of patients at an advanced stage, and delays in treatment. Ineffectiveness of treatment despite specific treatment in patients followed up with a diagnosis of TB should bring to mind the diagnosis of lung cancer and patients should be followed in this direction.

Keywords: Carcinogenesis, Lung Cancer, Tuberculosis

Sorumlu Yazar: Merve Ay�k T�rk, T�rkiye
Makale Dili: T�rk�e

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