同时性消化系多原发癌21例分析

Analysis on 21 cases with synchronous digestive multiple primary cancers

目的:探讨同时性消化系多原发癌的发病特点、诊治策略及预后因素。方法:对我院21例同时性消化系多原发癌患者的临床资料进行回顾性分析。结果:共纳入2 621例消化系恶性肿瘤患者,其中同时性多原发癌21例,发生率为0.8%(21/2 621);双原发癌18例,发生率为0.7%(18/2 621);三原发癌3例,发生率为0.11%(3/2 621)。其全部癌灶中好发部位依次为:结肠、胃、直肠、食管、肝脏、胆囊和胰腺,结肠病灶中又以右半结肠为最多。食管癌、胃癌、结肠癌、直肠癌5年生存率分别为20%、25%、42.9%和33.3%。结论:消化系多原发癌好发于消化道,最好发于结肠,以右半结肠为著,发生于结肠者预后较好。对消化系同时性多原发癌应尽量在手术根治的基础上结合放疗、化疗、介入治疗、免疫支持等综合措施,可提高疗效和改善预后。

Objective To study the morbidity characteristics, diagnosis, treatment strategies and prognosis factors of synchronous digestive multiple primary cancers. Methods Clinical data of 21 patients with synchronous digestive malignant tumors were retrospectively analyzed. Results A total of 2 621 patients with digestive cancer were enrolled in this study. 21 of 2 621 patients （0.8%） had multiple primary cancers, including 18 patients （0.7%） with double primary cancers and 3 patients （0.11%） with triple primary cancers. The leading cancer sites, in descending order, were colon, stomach, rectum, esophagus, liver, gallbladder and pancreas. The lesions in colon were almost in right colon. 5-year survival rates of esophageal, gastric, colon, rectal cancer patients were 20%, 25%, 42.9% and 33.3%, respectively. Conclusions The frequent locations of the digestive multi-primary cancers were the gastrointestinal tracts, and the most frequent locations were colon. The prognosis of patients with colon cancer was good. The treatment for digestive multi-primary cancers should be based on radical surgery combined with radiotherapy, chemotherapy, interventional therapy, immune support measures.