异时多原发肺癌的诊断和治疗  

Diagnosis and Treatment of Metachro nous Multiple Primary Lung Cancer

作　　者：赵峻[1] 张德超[1] 汪良骏[1] 张汝刚[1] 

机构地区：[1]中国医学科学院中国协和医科大学肿瘤医院肿瘤研究所胸外科,北京100021

出　　处：《癌症》2002年第7期764-767,共4页Chinese Journal of Cancer

摘　　要：背景与目的:对于异时多原发肺癌的诊断和治疗存在许多不同意见,目前尚无完全合理的诊断标准。本研究旨在探讨其诊断标准,比较不同治疗模式的生存结果。方法:对我院自1961年以来收治的44例异时多原发肺癌的临床资料进行回顾分析。结果:全组共44例,占我院同期收治肺癌病例的0.39%。其中再发癌与首发癌病理相同的23例,病理不同的21例;位于同侧肺的12例,位于双侧的33例。24例接受了手术,包括12例行根治切除。手术并发症发生率及术后死亡率分别为33.3%和8.3%。其余20例行放疗或/和化疗。手术组、根治手术组及非手术组的5年生存率分别为20.8%、33.4%和10.0%。结论:综合评估患者的临床特点可制定有利的诊断和治疗方案。手术组,尤其根治手术组的5年生存率明显高于非手术组。手术尤其是同侧再次手术应在有条件的医院由有经验的医师完成。Background &Objective:There is much controversy on the diag nosis and treatment of metachronous multiple primary lung cancer(MMPLC).Until now,there is no absolutely accurate diagnostic criteria.This study was designed to discuss its diagnosis,a nd to compare the survival rates afte r different therapeutic modalities.Methods:The clinical features of 44patients with MMPLC admitted to our hospital since 1961were analyzed retrospectively.Results:There were 44patients in this series,which accounted for 0.39%of all patients with lung cancer treated in our hospital.As to the initial cancer and the repeate d cancer,they shared the same pathological type in 23patients,and located on the same side of the lung in 12patients.Twent y-four patients received operation s,including 12curative patients.T he postoperative morbidity and mortality were 33.3%a nd 8.3%,respectively.The other 20p atients received radiotherapy or /a nd chemotherapy.The 5-year survival r ates of operative group,curative op erative group,and non-operative group were 20.8%,33.4%,and 10.0%,respectively.Conclusions:Comprehensive consideration of cli nical features may lead to a rational diagnosis and treatment strategy.5-year survival rate of the operative group,especially the curative grou p,is significantly higher than that of the non-operative group.The repeated operation,especially the second operation on the same sid e of the lung,should be performed at the qualified institutes and by the experienced doctors.

关 键 词：诊断 治疗 肺肿瘤 多原发性 外科手术 预后 

分 类 号：R734.2[医药卫生—肿瘤] R730.5[医药卫生—临床医学]