合并肺癌的多原发恶性肿瘤70例临床病理特征分析  

Analysis of clinicopathological characteristics of 70 cases of lung cancer combined with multiple primary malignancies

作　　者：程轩 孟璠璐 孙海凤 蒋喆 姚俊涛 CHENG Xuan;MENG Fanlu;SUN Haifeng;JIANG Zhe;YAO Juntao(Xi'an Medical University,Shaanxi Xi'an 710021,China;Department of Integrated Traditional Chinese and Western Medicine,Shaanxi Provincial Cancer Hospital Affiliated to Xi'an Jiaotong University Medicine School,Shaanxi Xi'an 710061,China)

机构地区：[1]西安医学院,陕西西安710021 [2]西安交通大学医学院附属陕西省肿瘤医院,陕西西安710061

出　　处：《现代肿瘤医学》2022年第23期4365-4369,共5页Journal of Modern Oncology

基　　金：北京市希思科临床肿瘤学研究基金会资助项目(编号:Y-QL202102-0175);陕西省中医管理局中医药科研课题(编号:15-LC041)。

摘　　要：目的:探讨合并肺癌的多原发恶性肿瘤(multiple primary malignancies,MPM)患者临床病理特征。方法:收集2017年01月01日至2019年12月31日陕西省肿瘤医院收治的3438例肺癌患者病例资料,回顾性分析其中70例合并肺癌MPM患者的临床病理特征。结果:同时多原发肿瘤(synchronous MPM,SMPM)16例,异时多原发肿瘤(metachronous MPM,MMPM)54例,男女比例为1∶1.06(男34例,女36例);入组病例次原发肿瘤发生的年龄为(61.37±11.22)岁;初原发肿瘤和次原发肿瘤发生平均时间间隔77.09月;肺癌先发组(lung cancer first,LCF)和其他器官肿瘤先发组(other cancer first,OCF)中肺癌病理类型均以肺腺癌最为多见,共42例(60.00%);肺癌分期为Ⅳ期患者共38例(54.29%);62.86%(44/70)患者伴有肺门或纵隔淋巴结转移;吸烟患者更容易出现SMPM。男性OCF组的初原发肿瘤中胃癌比例最高(31.82%,7/22),而原发性乳腺癌在女性中OCF组比例最高(32.26%,10/31)。结论:无病生存期超过5年的肿瘤患者应长期随访监测多原发肿瘤的发生;初原发乳腺癌、宫颈癌、胃癌患者应加强次原发肺癌的筛查,初原发肺癌患者应加强双原发肺癌及次原发胃癌、食管癌的筛查,以尽早发现MPM的发生,规范治疗,争取治愈机会。Objective:To explore the clinicopathological characteristics of patients with multiple primary malignancies(MPM)combined with lung cancer.Methods:3438 cases of lung cancer patients admitted to Shaanxi Provincial Cancer Hospital from January 01,2017 to December 31,2019 were collected,and the clinicopathological characteristics of 70 patients with lung cancer combined with MPM were retrospectively analyzed.Results:There were 16 cases with simultaneous multiple primary malignancies(SMPM)and 54 cases with metachronous multiple primary malignancies(MMPM),with a male to female ratio of 1∶1.06(34 males and 36 females).The age of secondary primary tumor in the enrolled cases was(61.37±11.22)years old.The average time interval between primary and secondary primary tumors was 77.09 months.Adenocarcinoma was the most common pathological type of lung cancer in the lung cancer first(LCF)and other cancer first(OCF)groups,with a total of 42 cases(60.00%).There were 38 cases(54.29%)with stage IV lung cancer.62.86%(44/70)patients had hilar or mediastinal lymph node metastasis.Smokers were more likely to develop SMPM.The proportion of gastric cancer was the highest in the male OCF group(31.82%,7/22),while the proportion of primary breast cancer in the female OCF group was the highest(32.26%,10/31).Conclusion:Cancer patients with disease-free survival of more than 5 years should be followed up for long-term monitoring of the occurrence of MPM.Patients with first primary breast cancer,cervical cancer and gastric cancer should strengthen the screening of secondary primary lung cancer,and patients with first primary lung cancer should strengthen the screening of double primary lung cancer and secondary primary gastric cancer and esophageal cancer,so as to detect MPM as soon as possible,conduct standardized treatment and strive for a chance to cure.

关 键 词：肺癌 多原发恶性肿瘤 临床病理特征 

分 类 号：R730[医药卫生—肿瘤]