Association between Tumor Epidermal Growth Factor Receptor Mutation and Pulmonary Tuberculosis in Patients with Adenocarcinoma of the Lungs

The possible association between pulmonary tuberculosis (TB) and lung cancer development has been studied for several decades. However, the association between epidermal growth factor receptor (EGFR) mutation status and pulmonary TB in patients with adenocarcinoma of the lungs is unknown. We reviewed the data of our patients with adenocarcinoma of the lungs who had a clinical history of pulmonary TB or old TB lesions shown on chest computed tomography scan and evaluated the association between tumor EGFR mutation status and pulmonary TB. From June 1999 to January 2011, there were 275 patients with pulmonary adenocarcinoma with tumor EGFR mutation data available for analysis. Of them, 191 patients had EGFR mutations, 17 had a clinical history of pulmonary TB infection, 72 had old TB lesions on chest computed tomography scans, and 14 had scar cancer. Patients with old TB lesions had a higher incidence of EGFR mutation than those without (p = 0.018). Exon 19 deletions occurred more frequently in patients with old TB lesions than in patients without (p < 0.001). Those patients with old TB lesions who had EGFR mutations or exon 19 mutations survived longer than those who did not (p = 0.014 and 0.001, respectively). Patients with exon 19 deletions and old TB lesions showed no survival difference compared with those with exon 19 deletions and without old TB lesions (p = 0.271). Patients with pulmonary adenocarcinoma who had scar cancer or had old TB lesions had a higher probability of having EGFR mutations, especially exon 19 deletions.