喉癌和喉咽癌的重复癌临床分析  

Retrospective analysis of multiple primary malignant tumor in patients with laryngeal and hypopharyngeal carcinoma

作　　者：李晓艳[1] 屠理强[1] 董频[1] 金斌[1] 王杰[1] 姜彦[1] 

机构地区：[1]上海交通大学第一人民医院耳鼻咽喉-头颈外科医学院耳鼻咽喉科研究所,上海200080

出　　处：《上海交通大学学报（医学版）》2007年第9期1065-1067,1087,共4页Journal of Shanghai Jiao tong University:Medical Science

基　　金：国家自然科学基金(30572031)(National Nature Science Foundation of China;30572031)

摘　　要：目的回顾性分析喉癌和喉咽癌发生重复癌的情况。方法收集1985～2004年间接受手术治疗的喉癌（n=239）和喉咽癌（n=55）患者的病史资料，294例中发生重复癌患者的情况进行回顾性分析。结果喉癌中发生重复癌29例（12．13％），喉咽癌中重复癌14例（25．45％），喉癌与喉咽癌患者重复癌的发生率有显著差异（P=0．012）。该组重复癌病例属同时性33例，异时性10例；发生主要部位在食道的有20例（46．51％）、甲状腺和肺部各7例（16．28％）和肺部（n=7，16．28％）。喉癌患者中发生与未发生重复癌患者的3年累积生存率有显著性差异（P=0．02）。重复癌接受治疗与放弃治疗患者的生存曲线比较有显著差异（P=0．0006）。结论头颈部是重复癌的高发部位，早期诊断和及时积极治疗，可提高患者生存率和生存质量。Objective To retrospectively analyze the events of multiple primary malignant tumor in patients with laryngeal and hypopharyngeal cancer. Methods Two hundred and ninety-four patients who were performed operations for laryngeal（n = 239） or hypopharyngeal squamous cell carcinoma（n =55） from 1985 to 2004 were included in this study. The events of multiple primary malignant tumor were retrospectively analysed. Results Of 239 patients with laryngeal cancer, multiple tumors were detected in 29 cases （ 12.13% ） , and of 55 patients with hypopharyngeal cancer, multiple tumors were detected in 14 cases （25.45%）. There was significant difference in the prevalence of multiple tumors between the patients with laryngeal cancer and hypopharyngeal cancer（ P = 0. 012）. Synchronous and metachroneous tumors were diagnosed in 33 and 10 patients, respectively. The second tumors were more often found in the esophagus （ n = 20,46.51% ） , thyroid gland （ n = 7,16.28% ） and lung （ n = 7, 16.28% ）. There was significant difference in the survival status between the laryngeal cancer with multiple cancer and without multiple cancer（P =0.02）. A significant difference（ P =0. 0006） in the survival status between the group with treatment and without treatment was found. Conclusion The incidence of multiple primary malignant tumor in patients with laryngeal and hypopharyngeal carcinoma is relatively higher. Early diagnosis and appropriate treatment may improve the quality of life and increase the survival rate.

关 键 词：喉癌 喉咽癌 重复癌 

分 类 号：R739.6[医药卫生—肿瘤]