141例多原发恶性肿瘤的临床分析

Multiple primary malignant neoplasms:clinical analysis of 141 cases

目的探讨141例多原发恶性肿瘤的临床特点、诊治原则及预后。方法收集解放军总医院自1975年1月到2006年4月住院的141例多原发恶性肿瘤患者,对其临床资料进行回顾性分析,采用SPSS15.0统计软件,生存时间以Kaplan-Meier生存曲线表示。结果141例患者(大于60岁者115例,占81.6%;小于60岁者26例,占18.4%)共发生321个恶性肿瘤,其中171个位于消化系统,59个位于泌尿系统,56个位于呼吸系统,其他35个发生于甲状腺、乳腺、子宫、四肢、口腔、颌面部、脑及血液系统。双原发癌106例,三原发癌32例,四原发癌2例,五原发癌1例。发生于消化系统恶性肿瘤中,常见的发生部位是胃(74例),其次是结肠(66例)、食管(14例),肝脏(9例),胆囊(4例),胰腺(4例)。结论多原发癌患者的好发部位与消化系统、呼吸系统、泌尿系统密切相关,治疗手段及两癌的间隔时间有关对其预后有影响,应对肿瘤患者进行长期认真的随访。定期随访、早发现、早诊断及积极有效的治疗有助于提高患者生存质量。

Objective To study the clinical characteristics, diagnosis and treatment strategy of multiple primary maligrumt neoplasms（MPMNs）. Methods A tolal of 141 cases of MPMNs admitted to our hospital between Jan. 1975 and Apr. 2006 were studied retrospectively. Of whom, 115 eases aged above 60 years, （81.60%）;26 cases aged below 60 years （18. 4%） Results There were 321 malignant neoplasms in the 141 MPMNs patients. Of these malignant neoplasms, 171were cases in alimentary system, 59 in urinary system, 56 in respiratory tract, and other 35 in thyroid, breast, uterus, limbs, oral cavity, maxillofacial region, brain and hematological system. In the alimentary system, malignant tumors were often found in stomach, colon, esophagus, liver, gall bladder and pancreas. Conclusion The common locations of MPMNs were closely associated with alimentary system, respiratory tract and urinary system. Patients with MPMNs must be submitted to a long-term and careful follow-up. Regular follow-up, early diagnosis and detection, active and effective treatment can help to improve the life quality of MPMNs patients.