乳腺癌合并多原发恶性肿瘤的临床特点  

Breast cancer in multiple primary malignant neoplasms, epidemiological and clinical analysis

作　　者：王成锋[1] 赵平[1] 白晓枫[1] 王海鹏[1] 白月奎[1] 

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

出　　处：《中华医学杂志》2002年第18期1229-1231,共3页National Medical Journal of China

摘　　要：目的　探讨乳腺癌合并多原发恶性肿瘤 (MPMN)的流行病学和临床特点。方法　回顾性分析 195 8～ 2 0 0 1年间经手术和病理证实的 5 19例乳腺癌合并MPMN的发病率、发病年龄、间隔时间、诊断、好发部位等临床和流行病学资料 ,并根据其临床特点分成 4组。双侧乳腺的双原发性乳腺癌 (第 1组 ) ;单侧乳腺的双原发性乳腺癌 (第 2组 ) ;乳腺癌伴其他脏器恶性肿瘤 (第 3组 ) ;乳腺癌作为第 2或 3原发癌的MPMN(第 4组 )。结果　 (1)第 1、2、3、4组的发病率分别为 3 0 %、0 8%、3 2 %、和 2 5 %。 (2 )第 1、2、3、4组的平均高发年龄分别为 4 2 5岁、4 7 3岁、5 1 4岁和 5 1 8岁。 (3)间隔时间分别为 5 4年、0、8 6、7 6年。 (4)第 3组伴其他脏器恶性肿瘤的好发部位依次为肺、子宫、食道、卵巢和大肠。 (5 )第 4组其第 1原发癌的好发部位依次为子宫、卵巢、大肠、淋巴组织和食道。 (6 )乳腺癌合并MPMN中乳腺被累及率为 72 4 %。结论　 (1)乳腺是MPMN的高发器官。 (2 )乳腺癌合并MPMN的好发器官多为与女性激素密切相关的脏器 ,如卵巢 ,子宫等。 (3)早期诊断和及时的治疗可取的满意的效果。Objective To investigate the epidemiological and clinical characteristics of breast cancer associated with multiple primary malignant neoplasmas (MPMNs). Methods The data of 519 patients of breast cancer associated with MPMNs admitted to the Cancer Hospital, CAMS and diagnosed by operation and pathology in the period of 1958 to 2001 were studied retrospectively to analyze the morbity, age of onset, sex ratio, predilection site of tumor, and the interval time between sequential tumors. The 519 patients, all female, were divided into four groups: bilateral primary breast cancer (1st group), synchronic Paget′s disease (PD) associated with breast cancer in the same breast (2nd group), breast cancer as the first tumor associated with MPMNs (3rd group), and breast cancer as the second or third tumour associated with MPMNs (4 th group). Results The constituent rate of bilateral primary breast cancer, synchronic Paget′s disease (PD) associated with breast cancer in the same breast, breast cancer as the first tumor associated with MPMNs, and breast cancer as the second or third primary tumour associated with MPMNs was 3.0%, 0.8%, 3.2%, and 2.5% respectively. The median age of onset was 42.5, 47.3, 51.4, and 51.8 years respectively for the four groups. The mean interval time between the appearance of the first tumor and the appearance of the second tumor was 5.4, 0, 8.6, and 7.6 years in the four groups respectively. The predilection sites of second and third primary cancers in the third group were lung, breast, esophageal, ovary, and large intestine. The predilection sites of first primary cancer in the 4th group were uterus, ovary, large intestine, lung, lymphatic tissue, and esophagus successively. The involvement rate of breast in breast cancer associated with MPMNs was 72.4%. Conclusion (1) Breast is one of the predilection organs of MPMNs. (2) The predilection organs of breast associated with MPMNs are the target organs of female hormone (eg, breast , ovary and uterus) and the organs involved by radi

关 键 词：临床特点 乳腺癌 多原发恶性肿瘤 发病率 MPMN 流行病学 

分 类 号：R737.9[医药卫生—肿瘤]