老年人多原发癌37例临床分析

目的 探讨老年人多原发癌的临床特点、术后辅助化疗对患者预后及后续肿瘤的影响.方法 选取220例老年恶性肿瘤患者,分析其中37例多原发癌的发病年龄、发病部位、术后辅助化疗状况、首癌与第2、第3癌的间隔时间、生存时间.结果 本组多原发癌37例,占老年恶性肿瘤的16.8%,其中异时性多原发癌35例,同时性多原发癌2例;首发癌、再发癌、第3癌发病的中位年龄分别为70、77、77.5岁;共有肿瘤病灶82个,胃肠道为好发部位,其中结直肠癌28例(34.2%),胃癌11例(13.4%).首癌术后化疗23例,未化疗14例,化疗组生存时间明显长于非放化疗组(x2=4.63,P=0.0427),两组生长次癌的时间分别为6年与4年(x2=1.63,P=0.207).次癌和第3癌发生的中位间隔时间化疗组7年,非化疗组2年,化疗组明显长于非化疗组(x2=4.255,p=0.043).第3癌术后化疗组中位生存时间3年6个月,非化疗组7个月(x2=4.62,P=0.0316).结论 对老年多原发癌患者,术后化疗可延长其生存时间,并可延迟后续肿瘤的发生.     

多原发癌46例临床分析

目的探讨多原发癌的临床特点、治疗和预后。方法分析首都医科大学石景山教学医院北京市石景山医院肿瘤科和北京中西医结合医院肿瘤科收治的46例多原发癌的发病年龄、发病部位、首发癌与第2原发癌的间隔时间以及生存时间。结果本组46例多原发癌中,异时性多原发癌41例,同时性多原发癌5例。首发癌和第2原发癌的中位年龄分别为69岁和77岁,胃肠道为好发部位。肿瘤间隔时间5年组的中位生存期为240个月,肿瘤间隔时间≤5年组的中位生存期为84个月,两组间差异具有统计学意义(P=0.005)。首发癌术后5年的生存率为76.1%。第2原发癌治疗后5年生存率为21.7%。第2原发癌手术组的中位生存时间为60个月,非手术组的中位生存时间为48个月,两组比较,差异具有统计学意义(P=0.032)。结论对于多原发癌患者,根治性手术可延长其生存时间,肿瘤间隔时间愈长,生存期愈长。对多原发癌患者的治疗应持积极态度,只要肿瘤及患者情况允许,应尽量手术切除。     

老年人大肠多原发癌外科治疗

目的：总结外科治疗老年人大肠多原发癌的经验。方法：对46例老年大肠多原发癌患者进行回顾性分析。结果：46例占同期老年人大肠癌的7.6％（46/608）,其中大肠重复癌16例（男12例,女4例）,大肠癌伴其他脏器癌30例（男14例,女16例）。同时性癌13例,异时性癌29例,同时伴异时性癌4例。异时性癌相距时间10个月至30年5个月。共完成手术83例次,未发生严重的并发症,随访率达100％,术后3、5、10、15、20年生存率分别为71.1％（27/38）、63.6％（21/33）、43.3％（13/30）、28.6％（8/28）、16.0％（4/25）,优于同期老年大肠单发癌。结论：要增强对老年人大肠多原发癌的防治意识,定期复查,使其早诊断、早治疗,以期获得更佳疗效。     

老年人多原发性恶性肿瘤50例临床分析

老年人多原发性恶性肿瘤５０例临床分析潘浩，卢国文一、临床资料我院１９７８年７月至１９９３年６月共收治多原发性癌１６８例，占同期恶性肿瘤患者的０．７％。其中６０岁以上者５０例，占同期多原发性癌的２９．８％，男性３８例，女性１２例。患者第２原发癌的发病年...     

大肠多原发癌临床分析42例

目的：探讨大肠多原发癌及其肠外器官恶性肿瘤的流行病学、临床病理特点及诊治方法．方法：对我院1980-2005年收治的42例大肠多原发癌及其肠外恶性肿瘤的临床、病理及随访资料进行回顾性分析．结果：本组病例占我院同期收治的所有大肠癌的3．10%(42/1354),其中同时性大肠多原发癌13例(0．96%)；异时性大肠多原发癌29例(2．14%)；合并肠外器官恶性肿瘤的有20例(1．48%)．大肠癌灶以右半结肠和直肠为多,肠外癌灶以胃、小肠、乳腺、卵巢、子宫为多；病理均以腺癌为主．共有12例(28．6%)符合遗传性非息肉病性大肠癌(HNPCC)阿姆斯特丹标准Ⅱ,16例(37．2%)符合中国人HNPCC诊断标准．结肠纤维镜检查有助于多原发癌的检出．结论：大肠多原发癌的发病率较高,其流行病学和临床病理特点突出．应注意重视结肠纤维镜检查,术中应仔细全面探查,加强术后随访有助于HNPCC的发现和诊断,以避免误诊漏诊．     

老年性上消化道多原发癌21例内镜、病理分析

0 引言上消化道是多原发癌的好发部位,近几年来国内报导逐渐增多,有资料统计约占上消化道肿瘤0.4%-10.07%.而老年性上消化道多原发癌的发病较多,为了解老年组上消化道多原发癌情况,统计了我院消化科1990/2000年10年间的上消化道内镜检查资料36916例,经内镜、病理诊断为上消化道癌3267例,多原发癌32例,其中老年性上消化道多原发癌21例,现将老年性多原发癌内镜检查结果、镜下发现部位及病理诊断分析如下:     

胆管癌临床治愈性切除术后的第二原发癌5例

１临床资料我院从１９７６０７／１９９７０６共收治胆管癌及乏特氏壶腹癌共３５０例，有２９５例接受手术治疗，其中临床治愈性切除１３３例．对这１３３例患者中的１１８例进行长期随访（随访率为８８７％），随访时间１ａ～７ａ，发现５例胃肠道第二原发癌，其中...     

大肠多原发癌19例临床分析

大肠多原发癌是指发生于大肠的2个或2个以上的原发癌,根据第二癌距第一癌的发病问期,又可分为同时性多原发癌(SC)和异时性多原发癌(MC),临床易漏诊或误诊.1998～2006年,我们共收治19例大肠多原发癌患者,现进行回顾性分析.     

消化道多原发恶性肿瘤610例的临床特点

多原发恶性肿瘤好发于消化系统，我科最近２ａ收治３４例累及消化系统的双原发恶性肿瘤，现结合近３ａ国内文献报道的６１０例就消化系统多原发恶性肿瘤的临床特点作一讨论．１　材料和方法我科收治的４例双原发恶性肿瘤分别为：男性６５岁，同时性直肠腺癌、胃窦部低分化腺癌：女性５１岁，异时性子宫内膜乳头状腺癌、胃印戒细胞癌；女性５６岁，异时性右乳腺癌、直肠中分化腺癌；女性５３岁，异时性右乳腺浸润性导管癌、胆管癌．结合这４例我们收集了１９９６／１９９８年间国内报道消化系统多原发恶性肿瘤的文献８１篇计６１０例．常见的…     

食管、贲门异时性重复癌1例

食管、贲门异时性重复癌临床少见,本例贲门癌术后11年出现食管癌,与长期胃食管反流损伤食管黏膜有关.提醒临床医生注意.     

上消化道多原发恶性肿瘤（附40例临床分析）

目的 探讨上消化道多原发恶性肿瘤的临床、病理及内镜下特点。方法 回顾性分析1995～2004年我院40例上消化道多原发恶性肿瘤病人临床资料。结果 本组病例占同期上消化道恶性肿瘤的0．68％，同时癌34例，异时癌6例，食管多原发癌5例，食管胃多原发癌19例，胃多原发癌16例。全部病灶受累及次数依次为食管、胃窦、贲门、胃体。结论 提高对上消化道多原发恶性肿瘤的认识，早诊早治是提高疗效的关键。     

Clinical analysis of multiple primary malignancies in the digestive system： A hospital-based study

AIM: To analyze the characteristics of multiple primary malignancies (MPMs) of digestive system; including incidence, types of tumor combinations, time intervals between development of multiple tumors, clinical course, and prognostic factors affecting survival and mortality. METHODS: Data from a total of 129 patients treated from January 1991 to December 2000 for pathologically proved MPMs, including at least one originating from the digestive system, were reviewed retrospectively. RESULTS: Among 129 patients, 120 (93.02%) had two primary cancers and 9 (6.98%) had three primary cancers. The major sites of MPMs of the digestive system were large intestine, stomach, and liver. Associated non-digestive cancers included 40 cases of gynecological cancers, of which 31 were carcinoma of cervix and 10 cases of genitourinary cancers, of which 5 were bladder cancers. Other cancers originated from the lung, breast, nasopharynx, larynx, thyroid, brain, muscle, and skin. Reproductive tract cancers, especially cervical, ovarian, bladder, and prostate cancers were the most commonly associated non-GI cancers, followed by cancer of the lung and breasts. Forty-three cases were synchronous, while the rest (86 cases) were metachronous cancers. Staging of MPMs and treatment regimes correlated with the prognosis between survival and non-survival groups. CONCLUSION: As advances in cancer therapy bring about a progressively larger percentage of long-term survivors, the proportion of patients with subsequent primary lesions will increase. Early diagnosis of these lesions, based on an awareness of the possibility of second and third cancers, and multidisciplinary treatment strategies will substantially increase the survival of these patients.     

34例与肺癌相关的多原发癌的临床分析

目的:探讨与肺癌相关的多原发癌的临床特点。方法:回顾性分析34例与肺癌相关的多原发癌患者的临床病历资料。结果:34例患者中,同时癌占38%(13/34),异时癌占62%(21/34)。在多原发癌中肺癌起病隐匿,首发症状以咳嗽、咯血、胸闷气促常见,无症状者16例。肺癌病理分型以腺癌最为常见。再罹患肺癌风险更高的是头颈部肿瘤,肺癌患者最易再罹患消化系统肿瘤。重癌切除率67.6%。第一原发癌中位生存期为4.5年,第二原发癌中位生存期为1年。多原发癌中肺癌发生的先后顺序与预后无明显相关性。结论:与肺癌相关的多原发癌有一定的临床特点,预后较好,应重视初诊肿瘤患者的随诊工作,早期发现,积极治疗,提高患者生存率。     

X-ray diagnosis of synchronous multiple primary carcinoma in the upper gastrointestinal tract

AIM:To analyze the radiological features of multiple primary carcinoma (MPC) in the upper gastrointestinal (GI) tract,study its biological characteristics and evaluate X-ray examination in its diagnosis. METHODS:Hypotonic double-contrast GI radiography was performed in 59 multiple primary carcinoma cases,pathologically proved by surgery or endoscopy biopsy. Radiological findings were analyzed. RESULTS:Of the 59 cases,esophageal MPC (EMPC) was seen in 24,esophageal and gastric MPC (EGMPC) in 27 and gastric M...     

Clinical implications of multiple colorectal carcinomas in hereditary nonpolyposis colorectal carcinoma

PURPOSE: An increased incidence of multiple (synchronous and metachronous) colorectal carcinomas has been reported in hereditary nonpolyposis colorectal cancer. This review was undertaken to determine the clinical implications of multiple colorectal carcinomas in hereditary nonpolyposis colorectal cancer. METHODS: A retrospective review of the records of patients in the hereditary nonpolyposis colorectal cancer registry at Roswell Park Cancer Institute who had either synchronous or metachronous colorectal carcinomas was conducted. RESULTS: Twenty-five of 93 patients with documented pathology were found to have multiple colorectal carcinomas. The mean age at diagnosis of the index colorectal carcinoma was 46.7 (range, 28–65) years. There were 7 (7.5 percent) patients with synchronous colorectal carcinomas and 20 (21.5 percent) patients with metachronous colorectal carcinomas. Two of the seven (28.6 percent) patients with synchronous colorectal carcinomas developed a metachronous colorectal carcinoma. In the patients with metachronous colorectal carcinomas, 29 metachronous events were noted: colon (23) and rectum (6). The mean and median time interval for metachronous colorectal carcinomas were 10.9 and 11.8 (range, 1.5–43.8) years, respectively. The mean times to first, second, and third events were 11.7 (range, 1.5–43.5), 7.9 (range, 2.7–18.7), and 12.3 (range, 11.8–12.7) years, respectively. The majority of patients with metachronous colorectal carcinomas did not have stage progression at the diagnosis of the metachronous colorectal carcinomas: 13 patients had lower or same stage at first event, 4 had lower or same stage at second event, and 2 patients had lower stage at third event. Three of 20 patients with metachronous colorectal carcinomas died of their disease. CONCLUSION: Multiple colorectal cancers are common in hereditary nonpolyposis colorectal cancer. Even though stage progression may not be evident at diagnosis of metachronous colorectal cancer, some of these patients will nevertheless die of their disease.Presented at the annual meeting of the Southeastern Surgical Congress, Atlanta, Georgia, February 2 to 4, 1998.     

老年人肝癌切除术围手术期肝功能损伤的临床研究

目的 研究老年人原发性肝癌肝切除术围手术期肝功能损伤的原因及防治措施,以提高其临床疗效.方法 回顾性分析原发性肝癌肝切除病例62例,老年组32例,非老年组30例,采用单因素分析和多元逐步回归模型分析围手术期老年组与非老年组、肝门阻断组和非阻断组、出血量多组(≥500 ml)和出血量少组(＜500 ml)肝功能损害的影响因素.结果 老年肝癌切除术后肝功能损伤的发生率为32.6%,肝功能衰竭的病死率为1.6%.单因素分析显示肝门阻断、术中出血、术中输血量及肿瘤大小与术后肝功损伤有关.多元逐步回归模型显示肝门阻断的标准化回归系数0.314,(t=2.272,P＜0.05),肝门阻断是决定术后肝功能损伤的独立因素.结论 老年肝癌肝切除术后肝功能损伤的主要原因是肝门阻断和术中大出血,提高手术技能、缩短肝门阻断时间和减少术中出血是预防老年人肝癌术后肝功能损伤的主要措施.