29例甲状腺癌相关异时性多原发癌临床分析

Clinical Analysis of 29 Cases with Metachronous Multiple Primary Cancers Involving Thyroid Cancer

目的阐述甲状腺癌合并异时性多原发恶性肿瘤临床特点,总结含有甲状腺癌的异时性多原发癌的临床诊治思路。方法回顾分析2005年8月至2015年8月我院共收治住院甲状腺癌相关的异时性多原发癌29例的临床病理资料。结果异时性甲状腺多原发癌占同期收治甲状腺癌的2.39%(29/1212)。甲状腺癌相关异时性多原发癌另一癌发生在乳腺9例、头颈部7例、肺部5例、消化系统3例、生殖系统2例、甲状腺1例、血液系统1例、泌尿系统1例。29例异时癌中甲状腺癌作为首发癌19例,第二原发癌乳腺癌最多。非甲状腺癌先发首发癌10例,第二原发癌头颈部肿瘤最多。甲状腺癌先发组首发癌与第二原发癌发病间隔时间明显长于非甲状腺癌先发组,有统计学意义。结论与甲状腺癌相关的异时性多原发癌有一定的临床特点,预后较好。应重视初诊肿瘤患者的随诊工作,早期发现,积极治疗,提高患者生存率。

Objective This study aimed to clarify the clinical characteristics of metachronous multiple primary cancers （MPC） involving thyroid cancer,is summarized with thoughts of clinical diagnosis and treatment of metachronous MPC involving thyroid cancer. Methods The medical records of 29 metachronous MPC involving thyroid cancer treated in our hospital from August 2005 to August 2015 were reviewed. Results Out of 1,212 thyroid cancer patients treated contemporarily, 29 （2.39%） were diagnosed with metachronous MPC involving thyroid cancer. Total of 9 of the 29 patients with metachronous MPC involving thyroid cancer suffered from other neoplasms involving the breast, 7 in the head and neck, 5 in lung, 3 in the digestive system, 1 in the urinary system, 1 in thyroid and 1 in the blood systems. The MPCs with the first primary thyroid cancer were 19 cases, most of the second primary cancers were breast cancer. The others were 10 case with most of the second primary cancer were the head and neck neoplasm. The time interval between the onset of the first primary cancer and the second were longer in group of first primary thyroid cancer than the other group, the difference was statistically significant. Conclusion Metachronous MPC involving thyroid cancer has its clinical characteristics, and the prognosis is relatively well. We should pay more attention to regular follow up than before. Early diagnosis and detection, also the active and effective treatment can help to improve the life quality of MPC patients.