肺重复癌的临床特点分析

Analysis of clinical character for patients with dual primary bronchogenic carcinoma

目的分析肺重复癌的临床特征、吸烟影响、肺癌与肺外器官恶性肿瘤间关系、治疗及预后。方法收集我院近10年收治的4 589例肺癌患者中肺重复癌患者31例进行回顾性分析。结果本组31例中腺癌12例,小细胞肺癌10例,鳞癌6例,支气管肺泡癌1例,腺鳞癌1例,大细胞癌1例。所合并的第一原发肿瘤为膀胱癌6例,宫颈癌3例,食管癌3例,胃癌3例,肾癌3例,肺癌3例,乳腺癌2例,甲状腺癌1例,左颌下腺淋巴上皮癌1例,嗅神经母细胞瘤1例,喉癌1例,鼻咽癌1例,脑胶质瘤1例,结肠癌1例,多发性骨髓瘤1例,其中28例患者行手术治疗,术后进行放化疗者26例,3例单纯放疗。两种原发肿瘤发生的时间间隔平均为55个月,有肿瘤家族史者8例,吸烟者22例。有咳嗽、咯血症状者22例。结论肺重复癌与第一原发性肺癌的临床特点与预后相似,吸烟率更高,肿瘤患者发生第二肿瘤的风险较大,放化疗及手术可能会诱发第二原发肿瘤的发生,肿瘤家族史是高危因素。定期复查,及时诊断,综合治疗可改善患者的预后。

Objective To analyze the clinical characteristics,smoking effect,and the relationship between multiple primary tumors（MPT） of the lung combined with other organs′ tumour and prognosis of the second primary lung cancer.Methods Thirty-one cases of dual primary bronchogenic carcinoma from 4 589 cases of lung cancer confirmed by pathology and cytology in recent 10 years from the hospital were retrospectively reviewed.Results The pathology examination showed that 12 cases were adenocarcinoma in the group,10 cases were small cell lung cancer,6 cases squamous carcinoma,1 case was adeno-squamous carcinoma,1 case bronchioloalveolar carcinoma.1 case big cell lung cancer.The combinated first primary tumours were listed below：6 cases were bladder cancer,3 cases cervical carcinoma,3 cases esophageal cancer,3 cases gastric cancer,3 cases renal carcinoma,3 cases lung cancer,2 cases breast cancer,1 case was thyroid cancer,1 case lymphlepitheliomas of left alivary gland,1 case blastoma of olfactory nerve,1 case laryngocarcinoma,1 case nasopharyngeal carcinoma,1 case brain glioma,1 case colon carcinoma,1 case multiple myeloma.There were 28 pateints who received surgical therapy and there were 26 cases who got chemo-and radiation-therapy after operation in the group.3 cases were simply radiated.The median time of interval between the two primary cancers was 55 months.There were 8 families who had tumour history.22 cases had smoking history.There were 8 families who had tumour history.There were 22 cases who had the symptoms of cough or hemoptysis.Conclusion Second primary lung cancers are similar to the first primary lung cancer in clinical characteristics and prognosis.The rate of somking is higher.Tumour pateints have high risk of second primary lung cancer.Family history of tumour presents high risk.Regular interval check,diagnosis in time and comprehensive treatment can improve the prognosis of the patients.