胃癌对营养和免疫不利，并增加结核病（TB）的风险。这项研究调查了已接受胃切除术或内镜黏膜下切除术（ESD）的胃癌患者中结核病的发生率和风险因素。该回顾性队列研究使用韩国国家保险索赔数据进行。我们定义了三个研究组（全胃切除、部分胃切除和 ESD）的胃癌诊断患者以及一个无癌症对照组。分析了各队列中潜在结核分枝杆菌感染（LTBI）筛查状态、结核病发生率和潜在混淆因素，并使用 Cox 比例风险模型分析了结核病的风险。所有患者中进行了 LTBI 检测的比例不到 1%，全胃切除、部分胃切除、ESD 和对照组中的结核病发生率分别为每 100,000 人年 473.8、287.4、199.4、111.1 次。与对照组相比，全胃切除组结核病发生率的危险比（HR）最高（HR：2.896，95% CI：2.559-2.337），而 ESD 组的危险比显著增加（HR：1.578，95% CI：1.957-1.980）。年龄、身体重量指数和缺乏锻炼是所有队列中的风险因素。共病也被视为风险因素，具体取决于队列类型。接受胃切除术或 ESD 的患者有结核病的风险增加，而这种风险与胃切除的范围有关。考虑到 LTBI 诊断测试的低率和队列中结核病的风险增加，需要为胃癌患者制定更具体和实用的结核病管理指南。© 2023。作者（S）独家许可给国际胃癌协会和日本胃癌协会。

Gastric cancer adversely affects nutrition and immunity, while increasing the risk of tuberculosis (TB). This study investigated the incidence and risk factors for TB in gastric cancer patients who had undergone gastrectomy or endoscopic submucosal dissection (ESD).This retrospective cohort study was conducted using Korean national insurance claims data. We defined three study groups (total gastrectomy, subtotal gastrectomy, and ESD) of patients diagnosed with gastric cancer plus a cancer-free control group. The latent TB infection (LTBI) screening status, TB incidence, and potential confounders in each cohort were analyzed, and the risk of TB was analyzed using a Cox proportional hazard model.LTBI tests were performed in less than 1% of all patients, and the TB incidence rates were 473.8, 287.4, 199.4, 111.1 events/100,000 person-years in the total gastrectomy, subtotal gastrectomy, ESD, and control cohorts, respectively. Compared to the control cohort, the total gastrectomy cohort showed the highest hazard ratio (HR) for TB incidence (HR: 2.896, 95% CI: 2.559-2.337), while the ESD cohort showed a significantly increased risk (HR: 1.578, 95% CI: 1.957-1.980). Age, body mass index, and lack of exercise were risk factors in all cohorts. Comorbidities were also considered risk factors, depending on the cohort type.Patients who underwent gastrectomy or ESD had an increased risk of TB, and this risk was correlated with the scope of gastrectomy. Considering the low rate of LTBI diagnostic tests and increased risk of TB in the study cohorts, more specific and practical guidelines for TB management are required for gastric cancer patients.© 2023. The Author(s) under exclusive licence to The International Gastric Cancer Association and The Japanese Gastric Cancer Association.