回顾性分析我院收治的肺结核合并肺癌患者及单纯肺结核患者的临床特征及检查结果，为该病早期鉴别诊断提供科学依据。

收集2013年6月至2017年12月间安徽医科大学附属巢湖医院收治的359例肺结核住院患者的临床资料、实验室检查等资料，根据有无合并肺癌分为肺结核伴发肺癌者47例和单纯肺结核者312例，描述性分析两者临床资料及实验室检查的差异。

肺结核伴发肺癌患者的平均年龄为64岁，单纯肺结核患者52岁。两者在刺激性干咳、胸痛、结核中毒症状方面的发生率无明显差异，肺结核伴发肺癌患者咯血发生率高于单纯肺结核患者，差异具有统计学意义(χ²＝8.021，P＝0.004)。肺结核伴发肺癌患者影像学CT显示空洞及团块阴影较单纯肺结核患者低，差异具有统计学意义(P<0.05)。在肿瘤标志物检测中，肺结核伴发肺癌患者和单纯肺结核患者癌胚抗原(carcino-embryonic antigen, CEA)分别为(12.4±0.4)ng/ml和(4.0±1.2)ng/ml。神经元特异性烯醇化酶(neuron-specific enolase, NSE)分别为(32.4±1.3)ng/ml和(6.4±0.8)ng/ml。肺结核伴发肺癌患者血清CEA、NSE、糖原211(glycogen211, CA211)、鳞状细胞相关抗原(squamous cell carcinoma, SCC)水平明显高于单纯肺结核患者，差异具有统计学意义(P<0.05)。

临床上对于有吸烟史、糖尿病史的老年肺结核患者，需警惕肺结核合并肺癌可能，需完善胸部CT及肿瘤标志物检则，以减少误诊、漏诊率。

To analyze the clinical characteristics and examination results of the patients with pulmonary tuberculosis complicated with lung cancer in order to provide a scientific basis for early differential diagnosis of the disease.

The clinical data, laboratory tests and other data of 359 inpatients with pulmonary tuberculosis admitted to our hospital from 2013 to 2017 were collected for this study. The patients were divided into an observation group and a control group according to the presence or absence of lung cancer. The differences between the two groups in clinical data and laboratory tests were descriptively analyzed.

The mean age of the observation group (64 years) was older than that of the control group (52 years). There was no significant difference in the incidence of irritating dry cough, chest pain and tuberculosis symptoms between the two groups. The incidence of hemoptysis in the observation group was higher than that of the control group (χ²=8.021, P=0.004). The radiographic and clumping shadows in the imaging CT were lower in the observation group than in the control group, and the difference was statistically significant (P<0.05). In the tumor marker detection, the levels of CEA were (12.38±0.39) ng/ml in the observation group and (4.02±1.23) ng/ml in the control group. The levels of NSE were (32.49±1.33) ng/ml in the observation group and (6.48±0.86) ng/ml in the control group. The levels of serum CEA, NSE, CA211 and SCC in the observation group were significantly higher than those of the control group (P<0.05).

Clinically, the elderly tuberculosis patients with a history of smoking and diabetes are high-risk population of lung carcinoma, and the chest CT and tumor marker test might reduce the misdiagnosis and missed diagnosis rate.