Research progress on lung cancer complicated with pulmonary tuberculosis: a narrative review

Background and Objective: Pulmonary tuberculosis (PTB) and lung cancer (LC) are both serious health threats and have a complex relationship. Research has shown that tuberculosis (TB) may induce LC through chronic inflammation. TB infection is also more common in LC patients than in the general population. Patients with LC and TB have a higher rate of misdiagnosis, missed diagnosis, and a worse prognosis. Thus, the diagnosis and treatment of patients with LC and TB are highly challenging. This narrative review aims to provide some information for clarification on the relationship between LC and TB. Methods: We searched for retrospective cohort studies, observational studies, systematic reviews, and meta-analyses published between the database’s inception and 2024 to retrieve relevant articles on TB and LC from the PubMed/MEDLINE database. Key Content and Findings: We outline the latest research on the relationship between pulmonary TB and LC, potential biological mechanisms, as well as the co-treatment of TB and the tumor. Conclusions: Chronic inflammatory stimulation, scar formation, DNA damage, immune dysfunction, and other mechanisms caused by TB are associated with the development and progression of LC. LC may also reactivate TB. Currently, there is no standard diagnosis and treatment plan for co-existent TB and LC. The fundamental principle of patient management is to balance anti-tumor and anti-TB treatments based on the patient’s physical condition and make comprehensive intervention decisions.