同时性上消化道多原发癌20例

20 cases simultaneous multiple primary carcinoma in upper gastrointestinal tract

目的 :探讨同时性上消化道多原发癌的诊断及外科治疗。方法 :对 1 990年至 2 0 0 3年间2 0例上消化道多原发癌的临床资料结合文献进行分析。结果 :食管病变以中下段多见 ,胃部病变多见于贲门 ,上消化道钡餐造影检查确诊 4例 (2 5 % ) ,胃镜检查确诊 1 2例 (70 .6 % ) ,8例患者术前漏诊。结论 :对食管贲门癌病人 ,应常规进行上消化道钡餐造影检查及胃镜检查 ,对早期病变行胃镜下碘染色检查 ,同时术中进行仔细的手术探查 ,可提高上消化道多原发癌的诊断率 。

Objective: To investigate the diagnosis and surgical treatment of simultaneous multiple primary carcinoma in upper gastrointestinal tract. Methods: Clinical data of 20 patients with multiple primary carcinoma in upper gastrointestinal tract were analysed from 1990 to 2003. Results: The most frequent sites involved were mid-lower esophagus segment of and cardia. 4 patients were diagnosed by X-ray(4/16), and 12 patients were diagnosed by gastroscopy(12/17). Missed diagnosis were found in 8 patients. Conclusion: Routine X-ray examination and gastroscopy of esophagus and stomach, esophageal dye-staining through gastroscopy, and attentive surgical exploration are important measures for diagnosis of multiple primary carcinoma in upper gastrointestinal tract.