Abstract
Lung cancer (LC) and pulmonary tuberculosis (TB) are the deadliest neoplastic and bacterial infectious diseases worldwide, respectively. Clinicians and pathologists have long discussed the co-existence of LC and TB, and several epidemiologic studies have presented evidence indicating that TB could be associated with the development of LC, particularly adenocarcinoma. Nonetheless, this data remains controversial, and the mechanism which could underlie the association remains largely unexplored. Some bioinformatic studies have shown that human cancer biopsies have a very high frequency of bacterial DNA integration; since Mycobacterium Tuberculosis (MTb) is an intracellular pathogen, it could play an active role in the cellular transformation. Our group performed an exploratory study in a cohort of 88 LC patients treated at the Instituto Nacional de Cancelorogía (INCan) of Mexico City to evaluate the presence of MTb DNA in LC tissue specimens. For the first time, our results show the presence of the MTb IS6110 transposon in 40.9% (n = 36/88) of patients with lung adenocarcinomas. Additionally, through in-situ PCR we identified the presence of IS6110 in the nuclei of tumor cells. Furthermore, shotgun sequencing from two samples identified traces of MTb genomes present in tumor tissue, suggesting that similar Mtb strains could be infecting both patients.
Highlights
Two critical diseases that are a frequent cause of morbidity and mortality are tuberculosis (TB) and lung cancer (LC)[1,2]
58% (51/88) of the patients were tested for EGFR mutations (EGFRm), and among these 47.1% (n = 24/51) had an EGFRm
The most commonly reported EGFRm was a deletion in exon 19, present in 54.2% of the cases (13/24) (Table 1)
Summary
Two critical diseases that are a frequent cause of morbidity and mortality are tuberculosis (TB) and lung cancer (LC)[1,2]. The WHO estimates that approximately 23% of the world population is infected by MTb, though only 1 in 10 individuals will develop active disease[3,4]. The importance of this infectious agent cannot be understated, and several world regions have gained control through public health measures, other areas are still under a considerable burden by pulmonary T B1. Infections seem to play a role, their specific mechanism remains elusive In this regard, a history of TB has been associated with LC development in several epidemiologic studies, for the development of a denocarcinoma[11]. The results emphasize the importance of LC screening in this patient subgroup, as there could be a need for a considerable follow-up after the infection has been treated[21]
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