多原发癌176例临床分析

A clinical analysis of 176 cases with multiple primary malignant tumor

目的分析多原发癌的临床情况。方法对176例多原发癌患者的病例资料进行回顾性分析。结果男女发病比例为2.26∶1,同时性多原发癌63例(35.8%),异时性多原发癌113例(64.2%)。多原发癌的发病高峰时间集中于首发癌后的5年内,约139例(79.0%),多原发癌时间间隔为0~336个月。消化系统是首发癌和多原发癌的好发部位,其中首发癌的高发器官为食管、胃、肠道(54.5%),二发癌高发的器官为肠道、肺、胃、食管(67.6%)。手术治疗、放疗、化疗是首发癌和多原发癌的重要治疗手段,多原发癌的手术率明显低于首发癌。结论临床需提高多原发癌的诊断意识,掌握多原发癌发病特点、诊疗方法,以提高治疗水平。

Objective To analyze the clinical situations of the multiple primary malignant tumor.MethodsOne hundred and seventy six cases with multiple primary malignant tumor were reviewed and analyzed.ResultsMale and female prevalence ratio of multiple primary malignant tumor was2.26∶1.Among them,the number of synchronous carcinoma cases was63(35.8%),while the number of metachronous carcinoma cases was113(64.2%).The peak of onset was the first five years was139(79.0%)after the first symptom.The interval of multiple primary malignant tumor was from0to336months.Multiple primary malignant tumor and the first primary carcinoma were easily found in digestive system.Esophagus,stomach and intestine had a high risk of getting the first primary carcinoma(545%),and intestine,lung,stomach and esophagus had a high risk of getting multiple primary malignant tumor(67.6%).Surgery,radiotherapy and chemotherapy were important treatments for the first primary carcinoma and the multiple primary malignant tumor.The rate of the surgery for multiple primary malignant tumor was obviously lower than the rate of the first primary carcinoma.ConclusionsIn order to improve the treatment level,it is necessary to raise the awareness of the diagnosis of multiple primary malignant tumor and to master its features and treatment.