15例食管癌伴发肺癌诊治分析

The Diagnosis and Treatment of Esophageal Cancer Associated with Lung Cancer:A Report of 15 Cases

目的:对食管癌伴发肺癌的发病特点、临床特性、治疗及预后进行探讨。方法:收集1983年1月至2002年12月期间天津医科大学附属肿瘤医院收治的食管癌患者3843例,对其中15例食管癌伴发肺癌患者的临床资料进行回顾性分析。结果:本组食管癌伴发肺癌共计15例,同时性多原发癌(Synchronous carcinoma,SC)6例,异时性多原发癌(Metachronous carcinoma,MC)9例。本组男性13例,女性2例,男女之比为6.5:1。发病年龄在54～73岁之间,中位年龄64岁,SC均为同时发现食管癌和肺癌,MC中两个肿瘤平均间隔5年1个月。本组15个食管癌病灶中手术切除率为66.7%;16个肺癌病灶手术切除率为31.3%。本组患者1,3,5年生存率分别为80.0%,46.7%和40.0%,6例SC患者1,3,5年生存率分别为50.0%,16.7%和16.7%;9例MC患者的1,3,5年生存率分别为100%,66.7%和55.6%。结论:食管癌伴发肺癌患者中男性明显多于女性;食管癌伴肺癌患者的预后并不比单发的食管癌、肺癌差,其中异时性癌预后明显好于同时性癌;手术治疗是决定食管癌伴发肺癌预后的关键性因素。

Objective： To study the pathogenesis, clinical specificity, treatment and prognosis of esophageal cancer associated with lung cancer. Methods： We reviewed cases of esophageal cancer associated with lung cancer seen in our hospital between January 1983 and October 2002 and analyzed the clinical information. Results： There were 15 cases of esophageal cancer associated with lung cancer in this study, including 6 cases of synchronous carcinoma （SC） and 9 cases of metachronous carcinoma （MC）. There were 13 males and 2 females, with a male to female ratio of 6.5：1. The age at the onset of the disease ranged from 54 to 73 years, with an average of 64. All SC cases were found to have esophageal cancer and lung cancer at the same time and the average interval between two cancers in patients with metachronous carcinomas was 5 years and 1 month. The resection rate of esophageal cancers in this study was 66.7%, and the resection rate of lung cancers was 31.3%. The 1-, 3- and 5-year survival rates of all cases were 80.0%, 46.7%, and 40.0%, respectively. The 1-, 3- and 5-year survival rates of the synchronous carcinoma patients were 50.0%, 16.7% and 16.7%, respectively. The 1-, 3- and 5-year survival rates of metachronous carcinoma patients were 100%, 66.7%, and 55.6%, respectively. Conclusion： There are more male patients than female patients diagnosed with esophageal cancer associated with lung cancer. The prognosis of esophageal carcinoma associated with lung cancer is similar to that of esophageal cancer or lung cancer alone. The prognosis of synchronous carcinoma is better than that of metachronous carcinoma. The key factor affecting the prognosis of esophageal cancer associated with lung cancer is radical surgery.