肺癌、淋巴瘤组成的多原发癌24例临床分析

Clinical analyses of 24 patients with multiple primary cancer of lung cancer and lymphoma

目的分析肺癌和淋巴瘤组成的多原发癌患者的临床特征,探讨肺癌和淋巴瘤之间的关系及多原发癌发生的危险因素。方法收集24例肺癌和淋巴瘤组成的多原发癌患者的病历资料,对患者的临床特征进行分析。结果24例肺癌和淋巴瘤组成的多原发癌患者中,同时性原发癌8例,异时性原发癌16例;第一原发癌为淋巴瘤21例,第一原发癌为肺癌3例;两种肿瘤发生的最长时间间隔为35年。第一原发癌为淋巴瘤的21例患者中,15例患者有大量吸烟史,6例患者有肿瘤家族史;17例患者接受化疗或联合放化疗;17例患者的临床分期为Ⅲ/Ⅳ期。第二原发肺癌的病理类型:腺癌17例,鳞状细胞癌2例,小细胞肺癌2例。第一原发癌为肺癌的3例患者,分别接受了手术、化疗和联合放化疗,其中1例患者有肺癌家族史及大量吸烟史。结论淋巴瘤和肺癌的发生可能存在一定的关联,随着肿瘤患者生存期的延长,第二原发癌的发生应引起临床重视。

Objective To analyze the clinical characteristics of multiple primary carcinoma of lung cancer and lymphoma, and to explore the relationship between lung cancer and lymphoma and the risk factors of multiple primary cancers. Method The clinical data of 24 patients with multiple primary cancer of lung cancer and lymphoma were collected and analyzed.Result Among the 24 patients with multiple primary cancer of lung cancer and lymphoma,lymphoma and lung cancer were diagnosed synchronously in 8 cases,while successively in 16 cases;the first primary cancer was lymphoma in 21 cases,and the first primary cancer was lung cancer in 3 cases.The longest time of interval between the two primary cancers was 35 years.Among 21 patients whose first primary cancer was lymphoma,15 cases had smoking history, 6 cases had family history of cancer;17 cases received chemotherapy or combined with radiotherapy,while 17 cases were diagnosed as stage Ⅲ/Ⅳ lymphoma.The pathological types of the second primary lung cancer were adenocarcinoma in 17 cases,squamous cell carcinoma in 2 cases and small cell lung cancer in 2 cases.Among 3 patients whose first primary cancer is lung cancer and received operation,chemotherapy or combined with radiotherapy,1 case had family history of lung cancer and smoking history.Conclusion The occurrence of lymphoma and lung cancer may be related to some extent.With the prolongation of the survival time of cancer patients,the occurrence of the second primary cancer should be paid more attention to.