老年多原发癌早期诊断与治疗

Early diagnosis and treatment of multiple primary malignant tumors in the elderly

目的 :总结多原发癌的早期诊断经验 ,探讨综合治疗方法。方法 :回顾 2 2年间诊断老年多原发癌 70例临床病理资料 ,男 6 8例 ,女 2例 ,发病年龄从 6 0到 90岁。双重癌 5 2例 ,三原发癌 18例。结果 :首癌早期诊断4 5例 ,次癌早期诊断 5 0例 ,第三癌早期诊断 14例 ,双原发癌早期诊断 2 6例 ,三原发癌早期诊断 9例。 13例腔内早期肿瘤经内镜治疗 ,达无病生存 ,中位数 6 0个月 ;诊断末癌后 5年以上 4 5例 ,5年生存 35 5 % (16 / 4 5 ) ) ;死亡4 6例 ,非肿瘤事件 2 0例 (占 4 3 4 7% )。结论 :临床症状无助早期诊断 ,肿瘤标志物、影像学检查是发现早期肿瘤的重要手段。心脑血管、呼吸、消化道疾病是影响老年多发癌患者生存时间的重要因素。

Objective:Experience of diagnosis for multipl e primary malignant tumors(MPMTs) in early stage was summarized in order to give proper treatment in the elderly Methods: Seventy cases of MPMT s patients aged from 60 to 90 year old admitted to our hospital in the period o f 1980 to 2002 were ananlyzed retrospectively There were 68 males and 2 femels fifty two cases of them had double primary malignant tumors and 18 cases had triple primary malignant tumors Results: Forty five cases,50 cases and 14 cases of them in the first, second and third primary malignant can cer were dignosed in early stage respectively There were 26 cases with double carcinoma and nine cases with triple cacer in the early stage thirteen cases wi th gastric carcinoma and bladder in early staging cancer were treated by endosco pic resection, of which median servival rate without cancer were 60 months(range ,6 to 120 months) The 5 year survival rate for patients with MPMTs was 35 5% Twenty of forty six deaths were not directly tumor related Conclu sion: Clinical symptem is not helpful for diagnosis of cancer in early s tage Tumor marks, endoscopy and BUS were important procedure for early diagnose s of MPMTs Causes included sudden death, respiratory failure and upper gastroi ntestinal tract bleeding affect the 5 year servival rate of the patients with M PMTs