子宫内膜癌合并多原发性肿瘤

【目的】探讨子宫内膜癌合并多原发癌的发生率、病因、诊断及预后。【方法】对45例子宫内膜癌合并多原发癌的临床及病理资料进行回顾性分析。【结果】本组子宫内膜癌合并多原发癌的发生率为3.2%(45/1389)；异期癌两癌发生间隔时间最短8个月，最长19年；间隔5年以上者62%(16/26)；子宫内膜癌合并生殖器官恶性肿瘤53%(24/45)，其中大部分为同期癌(19/24)；合并乳腺癌16%(7/45)；合并大肠癌11%(5/45)。先期癌的临床分期中、早期者87%，治疗均采用相应的根治性治疗，其中31%(8/26)有放疗史，23%(6/26)有化疗史。本组多原发癌的治疗，全部为根治性治疗，5年生存率为63%。【结论】①必须警惕子宫内膜癌合并生殖器官、乳腺、大肠等器官多原发癌的发生；②子宫内膜癌合并多原发癌的病因可能与共同的胚胎来源、共同的雌激素受体、放射线、抗癌药物的使用等因素有关。

Endometrial Carcinoma(EC)Accompanied with Multiple Primary Malignancy

【Objective】 To study the incidence, possible etiology, diagnosis and prognosis of endometrial carcinoma with multiple primary carcinom a. 【Method】 45 cases of EC with other primary tumors were eligible for the ret rospective study. 【Results】 Of 1389 cases with EC, the rate of EC accompanied wit h other primary carcinoma was 3.2% (45/1389); the interval between two tumors d iagnosed was ranged from 8 months to 19 years. The percentage of interval more t han 5 years accounted for 62% (16/26). Among these 45 patients, the percentage o f EC complicated by other reproductive tract tumor was 53%(24/45), of them, 19 were synchronous carcinoma. The rate of EC with breast cancer and colo-rectal carcinoma were 169%(7/45), and 11%(5/45) respectively. Clinical staging for pati ents with EC plus multiple primary malignancy were 30 with stage Ⅰ, 9 stage Ⅱ, 3 stage Ⅲ and 2 stage Ⅳ. All patients with first primary tumors were treated by radical treatment. While 8 cases were also treated by radiation and 6 cases t reated by chemotherapy. In this group, all multiple primary tumors were treated by radical therapy. The overall 5-year survival rate was 63%. 【Conclusions】 ①The possibility of second primary tumor, such as female reproductive tract tu mor , breast cancer, and colo-rectal carcinoma should be considered in the patients with EC. ②The etiology of EC with multiple primary tumor may be relevant to th e same embryonic histogenesis, estrogen receptor, radiotherapy and chemotherapy.