同时性胃大肠双原发癌患者的临床病理探讨

Clinical and pathological features of synchronous double primary cancer in stomach and large intestine

目的探讨同时性胃与大肠双原发癌临床、病理特点以及诊治和预后。方法 检索北京大学人民医院胃肠外科自2000年1月至2006年12月胃及大肠癌1117例，包括大肠癌766例，胃癌351例，回顾分析同时性胃与大肠双原发癌临床资料，并分组进行统计学分析。结果胃与大肠各组双原发癌共35例，占同期胃大肠恶性肿瘤的3．1％（35／1117）。大肠．大肠组15例，胃-胃组3例，大肠-肠外组13例，胃-胃外组9例，后两组均包括胃-大肠双原发癌5例。癌灶均位于胃和大肠的双原发癌多于胃大肠与其他器官双原发癌；大肠-大肠组3年生存率明显高于胃-胃组。结论双原发癌早期诊断，正确区分双原发癌与转移癌对于该病早期治疗、不漏治以及提高生存率有重要意义。

Objective To explore the clinical and pathological features of synchronous double primary cancer in stomach and large intestine. Methods The clinical data of 35 patients with synchronous double primary cancer in stomach and large intestine out of 1117 patients with gastric and colorectal cancers treated during the period from January 2001 to December 2006, including 766 cases of colorectal cancer and 351 cases of gastric cancer, were analyzed. Results The 35 patients of synchronous double primary cancer in stomach and large intestine, accounting for 3. 13% of the cases of gastric and colorectal cancers, 23 males and 12 females, aged 66. 7 （44- 89） , could be divided into 4 groups： intestine-intestine group （n = 15）, stomach-stomach group （ n = 3 ）, intestine-extra-intestine group （ n = 13）, and stomach-extra-stomach group （ n = 9） ; the last 2 groups included 5 case with their primary cancer located in stomach-and large intestine respectively. The number of cases with the 2 primary carcinoma foci both located in the entero-intestinal duct, stomach and large intestine, was 23, more than that of the cases with their 2 carcinoma foci located in stomach or large intestine and other organs respectively （ n = 12 ） . The 3-year survival rate of the large intestine-large intestine group was higher than that of the stomach - stomach group. Conclusion Early diagnosis, correct distinguishing of the primary and metastatic cancer play an important role in the treatment of synchronous double primary cancer and improvement of the prognosis.