三个癌瘤以上的多原发恶性肿瘤

Multiple primary malignant neoplasmas

目的 探讨 3个癌瘤以上的多原发恶性肿瘤 (MPMNs)的流行病学和临床特点。 方法回顾性分析 195 8年～ 2 0 0 1年收治的 12 5例患者的发病率、发病年龄、性别比、间隔时间、好发部位。结果 3个癌瘤以上的MPMNs的发病率为 0 0 90 %,其中 3、4、5MPMNs的发病率分别为 0 0 78%、0 0 0 9%和 0 0 0 1%;平均发病年龄为 6 4岁。男∶女为 1 0∶1 2。平均间隔时间为 7 1年 ,第 1和 2、2和3、3和 4、4和 5原发癌的间隔时间渐短 ,从 5 7减至 2 4年。 3年内为相邻两癌的高发时间。好发部位 :按单一器官计 3个癌瘤原发癌依次为 :大肠、乳腺、肺、食管、子宫和皮肤 ;4个癌瘤原发癌为 :大肠、乳腺、皮肤、胃、子宫和膀胱 ;5个癌瘤原发癌为 :大肠、乳腺、皮肤、腮腺。 结论 3个癌瘤以上的MPMNs的发生率有增多的倾向 ;发病年龄在逐渐增大 ;女性多于男性 ;第 1和 2、2和 3、3和 4、4和 5原发癌的时间间隔逐渐缩短 ;好发器官为同一器官 ,成对器官和同系统的器官。

Objective To investigate the epidemiological and clinical features of multiple primary malignant neoplasmas(MPMNs). Methods One hundred and twenty-five cases of more than or equal to three primary malignant neoplasmas detected in the period of 1958 to 2001 were studied retrospectively in terms of frequency, age of onset, sex ratio,tumor location and the interval between sequential tumors. Results The overall incidence of MPMNs was 0 090%; for three,four and five MPMNs was 0 078%,0 009% and 0 001%. The mean age of onset of MPMNs was 64 years. The sex ratio, of male to female, was 1 0∶1 2 The mean time interval was 7 1 years, and it reduced from 5.7 to 2.4 years in a decending order of the first, second, third, forth and fifth primary tumors. Three,four and five primary malignant neoplasmas were predicated respectively in the large intestine, breast, lung, esophagus,uterus, skin; the large intestine,breast, skin stomach, urinary bladder, uterus; and the large intestine,breast, skin, parotid glands. Conclusions The overall incidence of multiple primary malignant neoplasmas seems to ascend. The age of onset of MPMNs tends to be increase. The incidence of in women is higher than in men. The time interval from the first to fifth primary tumor is decreasing. The susceptible organs are identical organ, bigeminal organs or organs of the same system.