原发性肺癌消化道转移10例诊治分析

The analysis of diagnosis and treatment of 10 cases of digestive tract metastasis of primary lung cancer

目的探讨原发性肺癌消化道转移患者的临床表现、病理类型、诊治方法及治疗效果.方法选取2010年7月至2022年3月苏州大学附属第一医院收治的原发性肺癌伴消化道转移的患者的临床资料进行回顾性分析.结果期间收治的原发性肺癌伴消化道转移患者共10例,均为男性患者,平均年龄(61.7±9.3)岁.7例出现消化道症状如穿孔、梗阻、黑便;3例无明显消化道症状,因行PET-CT于诊断肺癌时同期发现.非同时发现的时间间隔为(301.3±289.5)d.术后病理为腺癌5例,大细胞癌2例,腺癌合并大细胞癌2例,腺鳞癌1例.消化道病变部位为小肠4例,胃2例,结肠2例,小肠合并结肠2例.有6例患者同期伴有其他非消化道部位的转移.共8例患者行消化道手术,其中急诊手术3例.随访过程中,有5例患者仍存活,其余5例平均存活时间(59.2±50.3)d.结论原发性肺癌伴消化道转移临床较为少见,但整体发生率不低.原发性肺癌患者一旦出现相应的腹部体征,需警惕消化道转移的可能.经积极诊断后尽早干预,能减少相应急腹症的发生,改善患者预后.

Objective To explore the clinical characteristics,pathologic type,diagnosis,treatment and prognosis of primary lung cancer patients with gastrointestinal metastasis.Methods A retrospective analysis of 10 primary lung cancer patients with gastrointestinal metastasis in the First Afiliated Hospital of Soochow University from July 2010 to March 2022 was performed.Results A total of 10 primary lung cancer patients with gastrointestinal metastases were admitted.All the patients were male,with a mean age(61.7±9.3)years.Digestive symptoms such as perforation,obstruction and melena occurred in 7 cases.3 cases had no symptom,which was diagnosed by PET-CT.The time interval of non-simultaneous detection was(301.3±289.5)days.Postoperative pathology showed adenocarcinoma in 5 cases,large cell carcinoma in 2 cases,adenocarcinoma with large cell cancer in 2 cases and adenosquamous carcinoma in 1 case.The lesions of digestive tract were small intestine in 4 cases,stomach in 2 cases,colon in 2 cases,small intestine with colon in 2 cases.There were 6 patients with other metastases.A total of 8 patients underwent surgery,of which 3 patients underwent emergency surgery.During the follow-up,5 patients were still alive,and the other 5 survived for(59.2±50.3)days.Conclusion Metastases from lung cancer to gastrointestinal tract are rare,but the incidence is not low.When lung cancer patients have abdominal symptoms,gastrointestinal metastasis should be considered.Early intervention after diagnosis can reduce the incidence of acute abdomen and improve the prognosis of patients.