Comparison of clinical and imaging features between pulmonary tuberculosis complicated with lung cancer and simple pulmonary tuberculosis: a systematic review and meta-analysis

Abstract

This review aimed to compare the clinical features and CT imaging features between patients with pulmonary tuberculosis (PTB) and lung cancer and patients with PTB alone. That would help to analyze the differences between the two and consequently providing a theoretical basis for the clinical diagnosis and treatment for the patients.Relevant case-control studies focusing on the clinical and CT imaging characteristics between PTB with lung cancer and PTB alone were systematically searched from five electronic databases. Odds ratios (ORs) and 95% confidence intervals (CIs) were calculated for comparison. As of 2021-07-06, a total of 1735 articles were retrieved.But only 15 articles were finally included for meta-analysis. The results showed a higher proportion of irritable cough, hemorrhagic pleural effusion and lower proportion of night sweating in PTB patients with lung cancer than in PTB patients, and the differences were statistically significant (irritable cough: OR = 2.43, 95% CI:

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“…20 The study showed no significant difference in most clinical symptoms of the patients in the two groups (persistent chest pain, chest distress, hemoptysis, fever, emaciation, and shortness of breath). 20 Nevertheless, it showed clinical characteristics to differentiate LC and PTB. Irritable cough was found to have a significantly higher frequency in PTB and LC in comparison with PTB only (OR 2.43).…”

“…Hence, the patients will get proper treatment. 20 The National Cancer Institute found that PTB is associated with an increased risk of LC (odds ratio/OR 2.1, 95% CI 1.4-3.1). PTB was associated with a 1.78fold increased risk of LC in smokers and adenocarcinoma (relative risk: 1.6; 95% CI 1.2-2.1).…”

“…The mechanism underlying the increased risk of cancer after PTB infection is inflammation and pulmonary fibrosis as inactive TB lesions. 21 A meta-analysis by Sun, et al (2022) provided a comparison of clinical and imaging features for LC with PTB and only PTB. 20 The study showed no significant difference in most clinical symptoms of the patients in the two groups (persistent chest pain, chest distress, hemoptysis, fever, emaciation, and shortness of breath).…”

“…21 A meta-analysis by Sun, et al (2022) provided a comparison of clinical and imaging features for LC with PTB and only PTB. 20 The study showed no significant difference in most clinical symptoms of the patients in the two groups (persistent chest pain, chest distress, hemoptysis, fever, emaciation, and shortness of breath). 20 Nevertheless, it showed clinical characteristics to differentiate LC and PTB.…”

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“…Tuberculosis patients have a 50% increased chance of developing LC. Those with a history of tuberculosis for more than 20 years are 2.5 times more likely to develop this disease ( Sun et al, 2022 ). Therefore, these patients must be monitored to prevent the development of this type of cancer, since the prognosis of the disease can also be affected ( Arrieta et al, 2022 ).…”