RT Journal Article
SR Electronic
T1 Risk factors for tuberculosis in patients with early gastric cancer: Is gastrectomy a significant risk factor for tuberculosis?
JF European Respiratory Journal
JO Eur Respir J
FD European Respiratory Society
SP P566
VO 40
IS Suppl 56
A1 Hee Seok Lee
A1 Sung Jin Nam
A1 Young Woo Kim
A1 Il Ju Choi
A1 Bin Hwangbo
YR 2012
UL http://erj.ersjournals.com/content/40/Suppl_56/P566.abstract
AB Since 1940s, many studies suggested the strong relationship between gastrectomy and the development of TB. But there is no study about the association between TB development and gastrectomy in patients with early gastric cancer (EGC)We used our EGC cohort confirmed pathologically by gastrectomy (pT1N0M0) or endoscopic mucosal resection (EMR) (pT1) between Jun 2001 and Dec 2008 and followed up with chest X ray over 1year. We searched an active TB case developed at least 3months after gastrectomy and EMR in EGC cohort retrospectively.Of total 1935 patients with EGC, 1495 patients were classified as gastrectomy cohort and 440 patients as EMR cohort. While only one patient (0.2%) was diagnosed as active TB in EMR cohort, 26 (1.7%) were diagnosed in gastrectomy cohort during the follow-up period. TB cumulative incidence showed significant difference between the two cohort (Log-Rank test P=0.030). Cox proportional multivariate analysis after adjustment with age, sex, and BMI group in EGC cohort showed hazard ratio of old TB lesion was 4.911 (95% CI 2.213-10.901) and that of gastrectomy was 8.599 (95% CI 1.155-64.000). In subgroup analysis using gastrectomy cohort, Cox proportional multivariate analysis after adjustment with age and sex showed hazard ratio of old TB lesion was 4.570 (95% CI 2.041-10.231) and postoperative weight reduction (per 10% compared with weight before gasterectomy) was 2.240 (95% CI 1.452-3.486).Gastrectomy and old TB lesion on chest radiograph were significant risk factor for TB development in EGC cohort and old TB lesion on chest radiograph and body weight loss after gastrectomy were too in gastrectomy cohort.