309例合并肺癌的多原发癌患者的临床特征及预后分析  

Clinical characteristics and prognosis of 309 patients with multiple primary cancer complicated with lung cancer

作　　者：孙玲娣 王坚 郭子铭 何敏 沙莎[1] 何佳[1] 刘佳 顾小伟[1] SUN Lingdi;WANG Jian;GUO Ziming;HE Min;SHA Sha;HE Jia;LIU Jia;GU Xiaowei(Department of Radiotherapy,Jiangyin People’s Hospital,Jiangyin 214400,Jiangsu,China)

机构地区：[1]江阴市人民医院放疗科,江苏江阴2144000

出　　处：《癌症进展》2022年第23期2405-2408,共4页Oncology Progress

基　　金：江苏省卫生健康委员会科研重点项目(ZD2021053)。

摘　　要：目的分析309例合并肺癌的多原发癌(MPC)患者的临床特征及预后。方法收集309例合并肺癌的MPC患者的病历资料,按肿瘤发生时间间隔分为同时性多原发癌(sMPC)和异时性多原发癌(m MPC),依据首发器官分为肺癌首发(LCF)和肺外器官首发(OCF)。比较合并肺癌的sMPC和mMPC患者的临床特征,分析受累器官分布情况、发病时间间隔情况及预后情况。结果309例合并肺癌的MPC患者共合并肿瘤332例次,累及器官前五名分别为胃、肺、食管、结直肠、乳腺。sMPC与mMPC合并肺癌的MPC患者首发癌年龄比较,差异有统计学意义(P﹤0.01)。LCF患者发病平均时间间隔明显短于OCF患者(P﹤0.01)。与首次确诊肿瘤未接受放疗和/或化疗患者的中位时间间隔41.0(5.6,80.2)个月相比,首次确诊肿瘤即接受放疗和/或化疗患者与第二原发癌的中位间隔时间更短,为32.6(7.1,73.6)个月(P﹤0.01)。以第一原发癌确诊时间计算,sMPC、LCF、男性、吸烟合并肺癌的MPC患者的中位总生存期(OS)分别明显短于mMPC、OCF、女性和不吸烟患者(P﹤0.01)。结论合并肺癌的MPC的发病率较高,常累及胃、肺、食管、结直肠、乳腺等器官,sMPC、LCF、首次确诊肿瘤即接受放疗和/或化疗、有吸烟史患者的预后较差。Objective The clinical characteristics and prognosis of 309 patients with multiple primary cancer(MPC)complicated with lung cancer were analyzed.Method The medical records of 309 MPC patients with lung cancer were collected.They were divided into synchronous multiple primary cancer(sMPC)and metachronous multiple primary cancer(mMPC)according to the time interval of tumor occurrence,and they were divided into the lung cancer first(LCF)and the other cancer first(OCF)according to the first organ.To compare the clinical characteristics of patients with sMPC and mMPC combined with lung cancer,and analyze the distribution of affected organs,time interval of onset and prognosis.Result A total of 309 MPC patients with lung cancer had 332 tumors,and the first five involved organs were stomach,lung,esophagus,colorectal and breast.There was statistically significant difference in the age of the first cancer between sMPC and mMPC patients with lung cancer(P<0.01).The average time interval of LCF patients was significantly shorter than that of OCF patients(P<0.01).Compared with the median time interval of 41.0(5.6,80.2)months for the patients with the first confirmed tumor who did not receive radiotherapy and/or chemotherapy,the median time interval between the patients with the first confirmed tumor and the second primary cancer who received radiotherapy and/or chemotherapy was 32.6(7.1,73.6)months(P<0.01).The median overall survival(OS)of sMPC,LCF,male and smoking MPC complicated with lung cancer patients were shorter than those of mMPC,OCF,female and non-smoking patients respectively(P<0.01)based on the time of diagnosis of the first primary cancer.Conclusion The incidence rate of MPC associated with lung cancer is high,often involving stomach,lung,esophagus,colorectal,breast and other organs.The prognosis of patients with sMPC,LCF,radiotherapy and/or chemotherapy after the first diagnosis of tumor,and those with smoking history is poor.

关 键 词：多原发癌 肺癌 同时性多原发癌 异时性多原发癌 

分 类 号：R734.2[医药卫生—肿瘤]