多发性原发性肺癌的诊断与治疗  

DIAGNOSIS AND MANAGEMENT OF THE MULTIPLE PRIMARY LUNG CANCER

作　　者：叶芃[1] 詹晓洪[1] 陈国兴[1] 周思伯[2] 

机构地区：[1]浙江省丽水市人民医院 [2]上海第二医科大学瑞金医院

出　　处：《河北医学》1999年第3期5-7,共3页Hebei Medicine

摘　　要：目的：总结多发性原发性肺癌（ＭＰＬＣ）的诊治经验。方法：回顾１９７５年３月至１９９７年１月间手术治疗ＭＰＬＣ的统计资料，采用Ｍａｒｔｉｎｉ和Ｍｅｌａｍｅｄ的ＭＰＬＣ诊断标准，分析诊治结果。结果：８８３例原发性肺癌中有ＭＰＬＣ２０例，发生率为２．２６％，均手术治疗，无手术死亡。其中同时癌９例，术前误诊为转移４例，术前漏诊２例，术后３年、５年、１０年生存率分别为５５．６％、１１．１％、０％。异时癌１１例，术前误诊为复发或转移５例，术后３年、５年、１０年生存率分别为８１．８％、４５．５％、１８．２％。结论：提高对ＭＰＬＣ的认识，重视胸片、ＣＴ、纤维支气管镜、痰脱落细胞学等常规检查，有助于ＭＰＬＣ的诊断。外科手术切除是ＭＰＬＣ安全、有效的首选治疗方案，尤其是异时癌，仍可以获得长期生存。Objective:To summarize our experience with multiple primary lung cancer (MPLC);Methods:The deta from our hospital in patients with MPLC from March 1975 to January 1997 were reviewed.The diagnosis of synchronous and metachronous MPLC were diagnosed by the criteria of martini and melamed.The outcome about diagnosis or surgical management were analysed.Result:Twenty of the 883 patients with primary lung cancer were found to have MPLC for a frequency of 2.26%.All patients with MPLC underwent resection,there were no perioperative deaths.Nine patients had synchronous cancers,six were misdiagnosed.After operation,3 year、5-year and 10-year survival rates for synchronous MPLC were 55.6%、11% and 0%,respectively.Eleven patients had metachronouscancers,five patients were misdiagnosed.The 3 year、5 year and 10 year survival rate for second metachronous cancers were 81.8%、45.5% and 18 2%,respectively.Conclusion:It may be reduced the misdiagnosis of MPLC,if we recognized MPLC and paied attention to chest radiograph、CT、flexible bronchoscopy and sputum cytologic testing,et al.Anaggressive surgical approch is safe and effective in most patients with MPLC,and is the first optional management,especially patients with metachronous cancers,long term survival is possible.

关 键 词：肺肿瘤 多原发肿瘤 诊断 外科手术 

分 类 号：R734.2[医药卫生—肿瘤]