胃癌合并即时性双原发癌的临床特征分析  

Diagnosis and treatment of gastric cancer with immediate double primary carcinoma

作　　者：姚海波[1] 张人超[1] 胡俊峰[1] 赵忠扩[1] 邵钦树[1] Yao Haibo;Zhang Renchao;Hu Junfeng;Zhao Zhongkuo;Shao Qinshu(Department of Gastrointestinal and Pancreatic Surgery,Zhejiang Provincial People′s Hospital,People′s Hospital of Hangzhou Medical College,Hangzhou 310014,China)

机构地区：[1]浙江省人民医院胃肠胰外科,杭州医学院附属人民医院,杭州310014

出　　处：《中华医学杂志》2020年第38期3001-3004,共4页National Medical Journal of China

基　　金：浙江省自然科学基金(LQ19H160013);浙江省医药卫生科技项目(2019323421)。

摘　　要：目的探讨胃癌合并即时性双原发癌的临床特点、诊治及预后。方法收集2016年1月至2019年6月浙江省人民医院符合胃癌合并即时性双原发癌诊断标准的患者的临床资料,并且对临床资料进行回顾性分析,同时对患者进行随访及预后分析。结果共发现胃癌合并即时性双原发癌患者29例,占同期1741例胃癌患者的1.7%。其中>70岁17例,占58.6%。男性25例,占86.2%。术后病理分期以早期胃癌为主(63.2%)。29例即时性双原发癌中,结直肠癌8例(27.6%),其次为食管癌7例(24.1%)。其余包括肺癌6例(20.7%),胰腺癌2例(6.9%),前列腺癌2例(6.9%),非霍奇金淋巴瘤1例(3.4%),壶腹部肿瘤1例(3.4%),胆管癌1例(3.4%),喉癌1例(3.4%)。手术治疗组的预后明显好于非手术治疗组(中位生存时间:21.0个月与13.0个月,P=0.014)。结论胃癌合并即时性双原发癌多发生于老年男性,胃癌早期的患者。在合并肿瘤中,以结直肠癌为主,应重视消化系统的筛查。治疗上应尽可能对每一原发肿瘤行根治性手术治疗。Objective To investigate the clinical characteristics,treatment and prognosis of gastric cancer complicated with immediate double primary cancer.Methods The clinical data of patients who met the diagnostic criteria of gastric cancer with immediate double primary cancer from January 2016 to June 2019 were analyzed retrospectively.Results There were 29 cases of gastric cancer with immediate double primary carcinoma,accounting for 1.7%of the 1741 patients with gastric cancer in the same period.Of these,17(58.6%)were more than 70 years of age.25 cases(86.2%)were male.The postoperative pathological staging was mainly for early gastric cancer(63.2%).Colorectal cancer accounted for 8 cases(27.6%),followed by esophageal cancer in 7 cases(24.1%).The others included 6 cases of lung cancer(20.7%),2 cases of pancreatic cancer(6.9%),2 cases of prostate cancer(6.9%),1 case of non-Hodgkin′s lymphoma(3.4%),1 case of ampullary tumor(3.4%),1 case of bile duct carcinoma(3.4%)and 1 case of laryngeal carcinoma(3.4%).The prognosis of the surgical treatment group was significantly better than that of the non-surgical treatment group(median survival time:21.0 months vs 13.0 months,P=0.014).Conclusion Gastric cancer complicated with immediate double primary cancer mostly occurs in elderly men and early gastric cancer patients.In the complicated tumor,colorectal cancer is the main cause,so we should pay attention to the screening of digestive system.Radical surgery should be performed as far as possible for each primary tumor.

关 键 词：胃肿瘤 即时性双原发癌 消化道肿瘤 

分 类 号：R735.2[医药卫生—肿瘤]