肺癌治療中の肺炎症例におけるPneumocystis jiroveciiPCR陽性例の存在
ニューモシスチス肺炎（PCP）はPneumocystis jirovecii（P. jirovecii）を病原体として発症する日和見感染であり，化学療法中等の免疫不全状態においては致死的となりうる合併症である．肺癌治療中にスリガラス影を伴う肺炎像を認めた症例でのPCR陽性率は，他の固形腫瘍治療中の患者群と比較して有意に高く，肺癌の存在，骨髄抑制，ステロイド投与，放射線照射による組織障害などが複合的に局所免疫を低下させている可能性がある．...
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| Published in | 日本内科学会雑誌 Vol. 101; no. 4; pp. 1075 - 1078 |
|---|---|
| Main Authors | , , , , , , , |
| Format | Journal Article |
| Language | Japanese |
| Published |
一般社団法人 日本内科学会
2012
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| Subjects | |
| Online Access | Get full text |
| ISSN | 0021-5384 1883-2083 |
| DOI | 10.2169/naika.101.1075 |
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| Abstract | ニューモシスチス肺炎（PCP）はPneumocystis jirovecii（P. jirovecii）を病原体として発症する日和見感染であり，化学療法中等の免疫不全状態においては致死的となりうる合併症である．肺癌治療中にスリガラス影を伴う肺炎像を認めた症例でのPCR陽性率は，他の固形腫瘍治療中の患者群と比較して有意に高く，肺癌の存在，骨髄抑制，ステロイド投与，放射線照射による組織障害などが複合的に局所免疫を低下させている可能性がある． |
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| AbstractList | ニューモシスチス肺炎（PCP）はPneumocystis jirovecii（P. jirovecii）を病原体として発症する日和見感染であり，化学療法中等の免疫不全状態においては致死的となりうる合併症である．肺癌治療中にスリガラス影を伴う肺炎像を認めた症例でのPCR陽性率は，他の固形腫瘍治療中の患者群と比較して有意に高く，肺癌の存在，骨髄抑制，ステロイド投与，放射線照射による組織障害などが複合的に局所免疫を低下させている可能性がある． |
| Author | 伊藤, 文隆 神谷, 文彦 大野, 康 遠渡, 純輝 舟口, 祝彦 湊口, 信也 森, 秀法 柳瀬, 恒明 |
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| References | 9) Barbounis V, et al: Pneumocystis carinii pneumonia in patients with solid tumors and lymphomas: predisposing factors and outcome. Anticancer Res 25: 651-655, 2005. 10) Thomas CF Jr, et al: Pneumocystis pneumonia. N Engl J Med 350: 2487-2498, 2004. 4) Wakefield AE, et al: Detection of Pneumocystis carinii with DNA amplification. Lancet 336: 451-453, 1990. 7) Helweg-Larsen J, et al: Detection of Pneumocystis DNA in samples from patients suspected of bacterial pneumonia-a case-control study. BMC Infect Dis 2: 28, 2002. 1) Sepkowitz KA, et al: Pneumocystis carinii pneumonia without acquired immunodeficiency syndrome. More patients, same risk. Arch Intern Med 155: 1125-1128, 1995. 5) Flori P, et al: Comparison between real-time PCR, conventional PCR and different staining techniques for diagnosing Pneumocystis jirovecii pneumonia from bronchoalveolar lavage specimens. J Med Microbiol 53: 603-607, 2004. 3) Sing A, et al: Evaluation of diagnostic value and epidemiological implications of PCR for Pneumocystis carinii in different immunosuppressed and immunocompetent patient groups. J Clin Microbiol 38: 1461-1467, 2000. 8) Ozsahin M, et al: CD4 and CD8 T-lymphocyte apoptosis can predict radiation-induced late toxicity: a prospective study in 399 patients. Clin Cancer Res 11: 7426-7433, 2005. 6) Maskell NA, et al: Asymptomatic carriage of Pneumocystis jiroveci in subjects undergoing bronchoscopy: a prospective study. Thorax 58: 594-597, 2003. 2) Ribes JA, et al: PCR detection of Pneumocystis carinii in bronchoalveolar lavage specimens: Analysis of sensitivity and specificity. J Clin Microbiol 35: 830-835, 1997. 11) Flori P, et al: Comparison between real-time PCR, conventional PCR and different staining techniques for diagnosing Pneumocystis jirovecii pneumonia from bronchoalveolar lavage specimens. J Med Microbiol 53: 603-607, 2004. 12) Rodriguez M, et al: Prevention of infection due to Pneumocystis spp. in human immunodeficiency virus-negative immunocompromised patients. Clin Microbiol Rev 17: 770-782, 2004. |
| References_xml | – reference: 3) Sing A, et al: Evaluation of diagnostic value and epidemiological implications of PCR for Pneumocystis carinii in different immunosuppressed and immunocompetent patient groups. J Clin Microbiol 38: 1461-1467, 2000. – reference: 2) Ribes JA, et al: PCR detection of Pneumocystis carinii in bronchoalveolar lavage specimens: Analysis of sensitivity and specificity. J Clin Microbiol 35: 830-835, 1997. – reference: 6) Maskell NA, et al: Asymptomatic carriage of Pneumocystis jiroveci in subjects undergoing bronchoscopy: a prospective study. Thorax 58: 594-597, 2003. – reference: 1) Sepkowitz KA, et al: Pneumocystis carinii pneumonia without acquired immunodeficiency syndrome. More patients, same risk. Arch Intern Med 155: 1125-1128, 1995. – reference: 4) Wakefield AE, et al: Detection of Pneumocystis carinii with DNA amplification. Lancet 336: 451-453, 1990. – reference: 11) Flori P, et al: Comparison between real-time PCR, conventional PCR and different staining techniques for diagnosing Pneumocystis jirovecii pneumonia from bronchoalveolar lavage specimens. J Med Microbiol 53: 603-607, 2004. – reference: 9) Barbounis V, et al: Pneumocystis carinii pneumonia in patients with solid tumors and lymphomas: predisposing factors and outcome. Anticancer Res 25: 651-655, 2005. – reference: 7) Helweg-Larsen J, et al: Detection of Pneumocystis DNA in samples from patients suspected of bacterial pneumonia-a case-control study. BMC Infect Dis 2: 28, 2002. – reference: 5) Flori P, et al: Comparison between real-time PCR, conventional PCR and different staining techniques for diagnosing Pneumocystis jirovecii pneumonia from bronchoalveolar lavage specimens. J Med Microbiol 53: 603-607, 2004. – reference: 10) Thomas CF Jr, et al: Pneumocystis pneumonia. N Engl J Med 350: 2487-2498, 2004. – reference: 12) Rodriguez M, et al: Prevention of infection due to Pneumocystis spp. in human immunodeficiency virus-negative immunocompromised patients. Clin Microbiol Rev 17: 770-782, 2004. – reference: 8) Ozsahin M, et al: CD4 and CD8 T-lymphocyte apoptosis can predict radiation-induced late toxicity: a prospective study in 399 patients. Clin Cancer Res 11: 7426-7433, 2005. |
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| SubjectTerms | Pneumocystis jirovecii polymerase chain reaction 肺炎 肺癌 |
| Title | 肺癌治療中の肺炎症例におけるPneumocystis jiroveciiPCR陽性例の存在 |
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