Clinical guidelines for the diagnosis and treatment of lung cancer complicated with tuberculosis in China (2025 edition)_Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Authors：

CHEN Chang ¹ , HE Yayi ¹ , HU Ying ² , ZHANG Jie ¹ , CHEN Shanhao ¹ , SUN Wenwen ¹ ,  MA Shaohua ³ ,  LIN Gen ² ,  LI Feng ⁴ ,  LI Liang ³ ,  LIU Lunxu ⁵ ,  ZHI Xiuyi ⁶ , Committee of Integrated Rehabilitation for Lung Cancer , Chinese Anti-Cancer Association; Chinese and Western Integrated Lung Cancer Committee of Chinese Anti-Cancer Association , Society of Tuberculosis, Chinese Medical Association

1. Shanghai Pulmonary Hospital, Tongji University, Shanghai, 200433, P. R. China;
2. Beijing Chest Hospital, Capital Medical University, Beijing, 100069, P. R. China;
3. Depatment of Thoracic Surgery, Peking University Cancer Hospital, Beijing, 100142, P. R. China;
4. Depatment of Thoracic Surgery, Shanghai Public Health Clinical Center, Shanghai, 201508, P. R. China;
5. Depatment of Thoracic Surgery, West China Hospital of Sichuan University, Chengdu, 610041, P. R. China;
6. Depatment of Thoracic Surgery, Xuanwu Hospital, Capital Medical University, Beijing, 100069, P. R. China;

Corresponding author：

MA Shaohua, Email: doctormsh@163.com; LIN Gen, Email: lingen@bjxkyy.cn; LI Feng, Email: dr_lif08@126.com; LI Liang, Email: liliang69@tb123.org; LIU Lunxu, Email: lunxu_liu@aliyun.com; ZHI Xiuyi, Email: xiuyizhi2015@163.con

Keywords：

Lung neoplasms; tuberculosis; epidemiology; multimodal diagnosis; individualized treatment; guidelines

DOI：

10.7507/1007-4848.202509088

Video：

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China is facing the double burden of high incidence of lung cancer and tuberculosis epidemic. Lung cancer combined with tuberculosis has a high incidence and complexity in clinical practice. High-risk groups include immunocompromised people, long-term smokers and people with a history of tuberculosis. The coexistence of the two diseases not only increases the difficulty of diagnosis and treatment decision-making, but also increases the risk of treatment-related adverse reactions and drug interactions. The guideline was developed by Committee of Integrated Rehabilitation for Lung Cancer, Chinese Anti-Cancer Association; Chinese and Western Integrated Lung Cancer Committee of Chinese Anti-Cancer Association; Society of Tuberculosis, Chinese Medical Association, aiming to standardize the diagnosis and treatment of lung cancer complicated with pulmonary tuberculosis. The guideline emphasizes the core position of combined diagnosis of multimodal imaging, etiology and pathology. It is proposed that anti-tuberculosis and anti-tumor treatment should be coordinated under the framework of multidisciplinary team, and drug interactions and timing optimization should be paid attention to. For surgical treatment, minimally invasive resection combined with systematic lymph node dissection is recommended after infection control. Systemic therapy requires individualized risk stratification and dynamic monitoring of efficacy and adverse reactions. Based on evidence-based medicine and Chinese clinical practice, combined with the accessibility of drugs and technologies, this guideline proposes a whole-process management pathway covering screening, diagnosis, treatment and follow-up, in order to improve the prognosis and quality of life of patients.

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