肺癌

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　　肺结核病人常感觉乏力、食欲不振、体重减轻、盗汗、干咳甚至咯血。炎症波及壁层胸膜时，相应胸壁会有刺痛，有慢性重症肺结核时，会损害呼吸功能，并出现渐进性的呼吸困难。
　　于是一些患者认为，这些症状和肺癌相似，是否会造成和后者同样严重的后果?甚至有人觉得，肺结核会伤肺，从而直接导致肺癌。其实这些担心都是多余的。
　　肺结核多发生于青年人，其临床症状、好发部位、影像学特征和化验室检查都同肺癌有区别。
　　肺结核好发于上肺的尖后段和下肺叶的背段，胸片和胸部CT显示肺内病灶有引流支气管征象、周围卫星灶，部分病人可出现钙化灶，但纵隔淋巴结肿大较少见。化验室检查血沉快，结核菌素试验阳性，血肿瘤标记物检查阴性。一般使用抗结核药物，就会取得较好的疗效。
　　而肺癌则中老年人比较多，除有刺激性干咳、痰中有血外，没有肺结核那些特有的乏力、盗汗等症状。它好发于上肺前段，胸片和胸部CT显示肺内病灶有毛刺、分叶。中晚期时，则表现有肺门和纵隔淋巴结肿大。一般依靠PET、PET―CT、血液肿瘤标记物，就可以帮助诊断。
　　不过，临床上确有一种特殊类型的肺癌与肺结核有关，也就是常说的“瘢痕癌”，多为肺腺癌。而事实上，老年肺癌病人同时合并有肺结核的更为多见，在诊断和治疗时应提高警惕。
　　更值得一提的是，有些肺癌合并有结核的病人正是由于以前患有结核、特别是淋巴结核，钙化的淋巴结阻止了肺癌沿淋巴管转移，临床治疗效果和预后反倒更让人满意。

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==== 汉译英 ====
TB patients often feel fatigue, loss of appetite, weight loss, night sweats, dry cough or hemoptysis. Inflammation spread to parietal pleura, the corresponding chest wall will be tingling, severe chronic pulmonary tuberculosis, it will damage respiratory function, and the emergence of progressive dyspnea.
A result, some patients believe that these symptoms and lung cancer are similar whether the cause and the latter equally serious consequences? Some people even think, tuberculosis can damage the lungs, which led directly to lung cancer. In fact, these concerns are unfounded.
Tuberculosis occurred mostly in young people, their clinical symptoms, predilection sites, imaging features and laboratory examination were different from the same lung cancer.
Predilection of tuberculosis in the lung and lower lobe posterior tip of the back section of chest radiography and chest CT showed signs of pulmonary lesions with drainage bronchus, surrounded by satellite lesions, some patients, there may be calcification, but the rare mediastinal lymph nodes. Laboratory examination ESR fast, tuberculin test positive, blood tumor marker examination negative. Commonly used anti-TB drugs, it will get better effect.
While lung cancer is the elderly are more, in addition to irritant dry cough, sputum with blood, there is no specific tuberculosis are fatigue, night sweats and other symptoms. It is better made in the preceding paragraph on the lungs, chest radiography and chest CT showed pulmonary lesions are burr, sub-leaves. Middle and late, then the manifestations of hilar and mediastinal lymph nodes. Generally rely on PET, PET-CT, the blood tumor markers, we can help diagnose.
However, the clinic does have a special type of lung cancer and tuberculosis, which is often said that the "scar cancer", mostly for lung cancer. In fact, lung cancer in elderly patients with concomitant pulmonary tuberculosis are more prevalent in the diagnosis and treatment should be vigilant.
It is worth mentioning is that some patients with lung cancer complicated with tuberculosis is suffering from TB due to the previous, especially the lymphatic system, prevents calcification of lymph nodes along the lymphatic metastasis of lung cancer, clinical treatment and prognosis of hand, more unsatisfactory.