肝癌相关多原发肿瘤的临床特征分析

Analysis of clinical features of multiple primary tumors associated with liver cancer

目的:探究肝癌相关多原发肿瘤的临床流行病学特点及预后。方法:自2010年8月至2023年6月北京大学第三医院肿瘤中心收治的恶性肿瘤患者中筛选出肝癌患者,收集患者基本信息、肝癌和其他肿瘤的发病信息,对比多原发癌患者与单纯肝癌患者,以及肝癌为第1原发肿瘤患者与肝癌为第2原发肿瘤患者的差异。结果:176例肝癌患者中肝癌合并肝外肿瘤共23例(13.1%),其中5例为同时性多原发肿瘤,18例为异时性多原发肿瘤。在18例异时性多原发肿瘤患者中,肝癌为第1原发肿瘤和第2原发肿瘤数均为9例。具有肿瘤家族史的肝癌患者更容易发生多原发肿瘤(χ2=5.22,P=0.030)。第1原发肿瘤为肝癌者比第2原发肿瘤为肝癌者具有更短的肿瘤发病间隔(35个月∶156个月,P=0.009),发病间隔与第1原发肿瘤的诊断年龄呈负相关(r=-0.60,P=0.009)。结论:肝癌相关多原发肿瘤易发生于具有肿瘤家族史的患者。第1原发肿瘤为肝癌者比第2原发肿瘤为肝癌者在肿瘤发病间隔上不同。

Objective:To explore the clinical epidemiological characteristics and survival outcomes of patients with multiple primary malignant tumors(MPMTs)combined with liver cancer.Methods:From August 2010 to June 2023,patients with liver cancer were selected from malignant tumor patients admitted to the Cancer Center of Peking University Third Hospital.The basic information of the patients and the incidence information of liver cancer and other tumors were collected to make comparisons between MPMTs and single liver cancer,also groups with liver cancer as the first or the second primary cancer.Results:The incidence of liver cancer combined with extraneous tumors was accounting for 13.1%(23/176)of liver cancer patients during the same period.Among the patients,5 had synchronous multiple primary tumors,and 18 had metachronous multiple primary tumors.Of these patients,9 had liver cancer as the first primary tumor,and 9 had liver cancer as the second primary tumor.Liver cancer patients with family history of cancer were more likely to have multiple primary tumors(χ2=5.22,P=0.030).Liver cancer as the first primary tumor had a shorter interval for multiple primary tumor onset compared to liver cancer as the second primary tumor(35 month vs.156 month,P=0.009).The onset interval was negatively correlated with the diagnosis age of the first primary tumor(r=-0.60,P=0.009).Conclusions:Multiple primary tumors associated with liver cancer tend to occur in patients with a family history of cancer.There was a difference in the tumor incidence interval between multiple primary cancers with liver cancer as the first primary tumor and multiple primary cancers with liver cancer as the second primary tumor.