肺結核與肺癌：病例對照研究

Pulmonary Tuberculosis and Lung Cancer : A Case-Control Study

李龍騰(Long-Teng Lee) ； 陳建仁(Chien-Jen Chen) ； 索任(Jen Suo) ； 陸坤泰(Kwen-Tay Luh) ； 林瑞雄(Ruey-Shiung Lin)

《台灣醫學》 1卷2期 (1997/03) Pp. 176-184

https://doi.org/10.6320/FJM.1997.1(2).05

摘要

肺癌是中外各國均極重視且致死率甚高的一種癌症。有關肺癌發生的危險因子之研究甚多，尤其是吸菸與二手菸暴露之影響，被探討最多。肺結核與肺癌間的關係也在一百多年前即開始被關心，但是，仍然沒有確定之結論。本研究以台北市三家大型醫療機構之肺癌住院病患287人為病例組，以年齡、性別及居住地為配對條件，在該醫院內科、家醫科及社區各選取548人及542人為對照組，進行病例對照研究結果發現，和醫院對照組及社區對照組比較，男性有肺結核病史者發生肺癌的危險性分別是無肺結核病史者21.04倍(95％信賴區間＝3.86-114.59 ) 和9.49倍(95％信賴區間＝3.70-24.31)；和社區對照組比較，女性有肺結核病史者發生肺癌的危險性是無肺結核病史者的42.09倍(95％信賴區間＝3.63-487.85)，顯示肺結核和肺癌間具有顯著的關係。在控制吸菸等之影響後，其效應仍很顯著。
未來的研究方向，將是探討肺結核病在肺癌形成的過程所扮演的角色，以期改善這兩種疾病的防治。

關鍵字

肺結核 ； 肺癌 ； 病例對照研究

並列摘要

Lung cancer is an important disease with a very high fatality rate in many countries. There have been many investigations on the risk factors of lung cancer. The effects of active and passive cigarette smoking are of most concern. The association between pulmonary tuberculosis and lung cancer has been discussed since more than 100 years ago, but remains controversial. The purpose of this study was to evaluate the relationship of pulmonary tuberculosis and lung cancer. We recruited 287 lung cancer inpatients from three different hospitals in Taipei City as a case group, 584 inpatients from the Departments of Internal Medicine and Family Medicine of the study hospitals and 542 residents from the community as hospital controls and community controls, respectively. Cases and controls were matched for age, sex, and residential area. The results showed that males who had a history of pulmonary tuberculosis had 21.0 and 9.5 times the risk of lung cancer of those who had never been affected with pulmonary tuberculosis from the hospital and community samples, respectively. Females who had a history of pulmonary tuberculosis had 42.1 times the risk of lung cancer of those without it as compared to the community controls. The effect of tuberculosis on lung cancer remained statistically significant after adjustment for cigarette smoking and other factors, including drinking habit, vitamine intake, and intake of smoked foods. The further investigation should focus on the role of pulmonary tuberculosis in the development of lung cancer.

並列關鍵字

pulmonary tuberculosis ； lung cancer ； case-control study