5201例口腔合页面肿瘤统计分析

目的　通过分析广西医科大学 1970～ 1989年 2 0年间口腔颌面部肿瘤的病理检查资料 (来自广西各地区 ) ,进一步了解口腔颌面部肿瘤的发病状况。方法　分析经病理检查首次确诊原发于口腔颌面部肿瘤 52 0 1例 ,按其性质、组织类型、性别、就诊年龄与部位进行统计分析 ,并与首次确诊的全身原发肿瘤进行比较。结果　口腔颌面部肿瘤占全身肿瘤的 7 6 7% ,占头颈肿瘤19 39% ,恶性肿瘤略高于良性 ,恶性肿瘤男女之比 1 6 8∶1,良性肿瘤高发年龄组为 2 1～ 30岁 ,恶性肿瘤高发年龄组为 51～ 6 0岁 ,恶性肿瘤中以癌为最多 (82 0 7% ) ,而癌中以鳞状细胞癌最多 ,好发于舌部。结论　我校病理检查的口腔颌面部肿瘤各构成比 ,除恶性肿瘤高于良性外 ,基本上与国内外各地区的报告相似。     

口腔多发原发性肿瘤的冷冻治疗

莫斯科肿瘤医院1952～1984年收治口腔多发原发性肿瘤32例,占所有恶性肿瘤的0.3%,占头颈部恶性肿瘤3.3%,占头颈部多发原发性肿瘤的13.3%。多发原发性肿瘤完全定位于口腔者12例,以舌癌和口底癌为最多。第一肿瘤定位于口腔,第二肿瘤在其它器官者20例:喉癌7例,肺癌4例,乳腺癌3例,子宫颈癌2例。食管癌2例,胃癌1例,直肠癌1例。有2个原发肿瘤者30例(93.7%),有3个原发肿瘤者2例(6.3%)。同步性多发肿瘤12例,非同步性多发肿瘤     

转移性口腔颌面部肿瘤

转移性口腔颌面部肿瘤比较少见，约占口腔恶性肿瘤的1%，我院20多年中发现15例全身性肿瘤转移到口腔颌面部，其中口腔颌面部软组织转移12例，骨及软组织同时被侵犯2例，单纯颌骨转移1例，15例中以肺癌转移到口腔颌面部最多为6例，其次为乳腺癌及女性生殖器癌等，对转移性口腔颌面部肿瘤进行了详细讨论，提出了转移癌的诊断，治疗和预后等问题。     

98例牙龈癌临床分析

牙龈癌是口腔部较为常见的一种恶性肿瘤,据统计占整个口腔恶性肿瘤的7.7%～21.9%,本资料为15.4%。性别上以男性居多,男:女=3.1:1,发病年龄为18～74岁,50～59岁为高发年龄组。病变部位以下牙龈居多。病理类型中癌占96.9%(95/98),其巾又以高、中度分化鳞癌为主,占本组的76.8%(73/95)。按1987年 UICC 标准进行分期,治疗方式包括单纯手术、放疗、化疗及该2～3种方式的综合。结果表明以单纯手术及手+放疗的效果较好,5年生存率分别为38.5%和42.9%,而病期的早晚也明显地决定着患者的生存率。     

头颈部原发肿瘤3339例统计分析

 本文分析我院1979～1993年间首次经病理确诊的头颈部原发肿瘤3339例,占同期全身肿瘤23.9%(339l/3914),低于王安宇、游孟高报道的39.5%与37.66%,高于山西省肿瘤医院报道的17.9%。     

儿童实体肿瘤1324例临床病理分析

目的：探讨近20a儿童肿瘤发病变化趋势及病理特点，为临床医师和病理医师提供有价值的肿瘤病理资料。方法：材料选自天津医科大学总医院和第二医院病理科1981年至2000年20年间临床外科病理检查档案中的肿瘤病例年龄在14a(包括14a)以下者，以：Microsoft excel表格形式存储，应用Microsoft access对资料分类筛选，应用Spss10．0版对该分类资料进行列联表式统计描述。结果：20a间227702例外检病例中共检出肿瘤47626例，14a以下儿童肿瘤l324例，占全部外检肿瘤总数的2．78％，其中良性肿瘤l106例，恶性218例。良性和恶性肿瘤均呈下降趋势。良恶性肿瘤男女性别比例不同：良性肿瘤女性高于男性，而恶性肿瘤男性高于女性。肿瘤的组织学类型：良性肿瘤以软组织起源的肿瘤最多见，约占49．46％，其次为上皮性肿瘤，占13．20％，骨及关节肿瘤占第三位，8．59％；恶性肿瘤以胚胎性肿瘤和肉瘤构成比较高，分别为30.73％，25．69％，第三位是恶性淋巴瘤，占19．27％，上皮性恶性肿瘤所占比例较小，占11．01％。肿瘤的年龄趋势：良性肿瘤中毛细血管瘤1a以内高发，乳腺纤维腺瘤、骨肿瘤以10～14a年龄组高发；恶性肿瘤中胚胎性肿瘤和肉瘤以1～4a年龄组高发，癌的发病年龄较大，10～14a年龄组检出率最高，淋巴瘤高发年龄不显著。结论：儿童肿瘤的组织学特点不同于成人肿瘤，其发病机制亦不同于成人，儿童肿瘤的关键在于预防，做好优生优育，减少产前与产后致癌物的接触。     

小涎腺肿瘤60例临床分析

目的　探讨小涎腺肿瘤的发病情况 ,临床特点及诊断治疗。方法　对 1 980～ 1 995年间收治的经病理确诊的 60例小涎腺肿瘤的年龄、性别、好发部位、诊断、治疗等进行了回顾性综合分析。结果　 60例口腔小涎腺肿瘤 ,良性肿瘤 2 6例占 43 .33 % ,恶性肿瘤 34例占 56 .67% ,良性肿瘤中的混合瘤多见占良性肿瘤的 69.2 3 % ,恶性肿瘤中以黏液表皮样癌为多 ,1 4例占恶性肿瘤的 41 .1 8% ,手术 +放疗者占恶性肿瘤的 38.2 4 % ,5年生存率为 68.97%。结论　小涎腺肿瘤中恶性肿瘤多于良性肿瘤。术前X线检查和术中冰冻病理检查对诊断和治疗方案有指导意义。首次手术彻底性是防止复发的关键。术后辅助放疗可降低恶性肿瘤复发率     

52年间9 056例口腔颌面部肿瘤类疾病构成

目的了解口腔颌面部肿瘤、囊肿与瘤样病变的临床病理情况及构成特点。方法分析在本院口腔颌面外科住院首诊且经病理确诊的口腔颌面部肿瘤、囊肿和瘤样病变9056例，按其性质、组织类型、性别及部位等进行回顾性统计分析。结果口腔颌面部肿瘤6337例，囊肿2363例，瘤样病变356例。肿瘤中良性占56．7％（3596／6337），恶性占43．3％（2747／6337）；良性肿瘤常见的依次为多形性腺瘤、血管瘤和成釉细胞瘤；恶性肿瘤中以癌最常见，占86．2％（2367／2747），尤其是鳞癌居癌中之首（50．0％，1184／2367，男女之比2．34：1）；好发部位依次为舌、牙龈、颊等。涎腺良、恶性肿瘤中分别以多形性腺瘤和腺癌多见，好发部位分别以腮腺、颌下腺、腭腺和腮腺、腭腺、颌下腺多见。牙源性和非牙源性囊肿中分别以含牙囊肿（33．9％，408／1202）和舌下腺囊肿（41．1％，477／1161）最多见。瘤样病变以牙龈瘤（54．8％，195／356）多见。结论口腔颌面部肿瘤、囊肿和瘤样病变中肿瘤最常见，其中良性肿瘤较恶性肿瘤多见，男性较女性多见。     

口腔颌面部恶性肿瘤颈淋巴转移的临床病理学特征分析

目的　探讨口腔颌面部恶性肿瘤颈淋巴转移的特征和规律 ,为临床颈淋巴清扫术提供依据。方法　对 65例颈淋巴清扫术标本进行病理检查 ,并与原发灶特征及淋巴结扪诊状况综合分析。结果　口腔颌面部恶性肿瘤颈淋巴转移率为 46.2 % ,其中N0～N1a病例转移率为 3 6.4% ,N1b～N2b转移率为 66.7% ;上颌牙龈癌、口咽癌、舌癌、颌骨中央性癌及口底癌颈淋巴转移率较高 ,而 8例下颌牙龈癌无一例转移 ;原发灶肿瘤分化程度越低 ,转移率越高 ;另外 ,对颈清扫标本进行连续切片发现 ,7例肿大淋巴结无转移 ,但标本中可见微转移灶。结论　口腔颌面部恶性肿瘤颈淋巴转移与原发灶部位、分化程度及颈淋巴结扪诊断状况有关 ;对颈清扫物有必要行连续切片检查。     

3436例口腔粘膜鳞状细胞癌发病情况分析

鳞状细胞癌（以下简称鳞癌）是口腔颌面部最常见的恶性肿瘤，而原发于口腔粘膜者约占颌面部鳞癌的８０％。本组资料对华西医科大学口腔医院１９５３年～２０００年６月收治的３４３６例口腔粘膜鳞癌的原发部位、性别、年龄的构成比及逐年变化情况进行统计分析。１临床资料材料来源于华西医科大学１９５３年建立口腔颌面外科病室至２０００年６月中发生于固有口腔、口腔前庭及上下唇粘膜的鳞癌住院病案（按出院病例主肿瘤部位按UICC１９８７年的临床TNM分类，肿瘤病理参照WHO１９９０年的国际肿瘤疾病分类。２结果２．１３４３６例口腔粘…     

Clinicopathologic and familial characteristics of endometrial carcinoma with multiple primary carcinomas in relation to the loss of protein expression of MSH2 and MLH1

BACKGROUND: The frequency of synchronous or metachronous multiple primary carcinomas in patients with endometrial carcinoma has been reported to be between 10% and 23% and is highest among all gynecologic carcinomas. However, clinical characteristics and underlying genetic abnormalities in endometrial carcinoma with multiple primary carcinomas has not been well clarified. Endometrial carcinoma is the most commonly associated extracolonic malignancy in hereditary nonpolyposis colorectal carcinoma in which germ line mutations in DNA mismatch repair genes, particularly in MSH2 and MLH1, are known to cause this syndrome. The purpose of the current study was to investigate clinicopathologic and familial characteristics including MSH2, MLH1, and p53 expression in endometrial carcinoma with multiple primary carcinomas, by comparing them to endometrial carcinoma without other primary malignancies. METHODS: Patients were divided into two groups: 30 patients with synchronous or metachronous multiple primary carcinomas other than endometrial carcinoma and 116 patients with endometrial carcinoma without other primary malignancies. Clinicopathologic characteristics, family history of cancer, and immunohistochemical protein expression of MSH2, MLH1, and p53 expression were investigated in both groups, and 15 endometria from benign disease were used for normal controls in immunohistochemistry. RESULTS: The frequency of high risk clinicopathologic factors of endometrial carcinoma and 5-year survival rates and the frequency of p53 overexpression were not statistically different between the two groups. However, the loss of MSH2 and/or MLH1 expression was significant in endometrial carcinoma with multiple primary carcinomas, when compared with endometrial carcinoma alone (22 of 30 vs. 31 of 116). In cases with multiple primary carcinomas, particularly those diagnosed before the patient was 55 years of age or those in which the patient had a family history of cancer, the frequency of this loss was especially high (11 of 13 and 10 of 11, respectively). CONCLUSIONS: The clinical or biologic nature of endometrial carcinoma with multiple primary carcinomas seems to be similar to endometrial carcinoma alone. A high incidence of defective MSH2 and MLH1 protein in endometrial carcinoma with multiple primary carcinomas, however, suggests that abnormalities in the function of MSH2 and MLH1 may play an important role in tumorigenesis for patients with endometrial carcinoma with multiple primary carcinomas and their families.     

肺肿瘤患者临床病理特征回顾性分析

目的:分析肺肿瘤患者的临床流行病学及临床病理特征。方法:回顾性分析中国医学科学院肿瘤医院2008-01-2008-12住院的1 729例肺肿瘤患者资料,包括居住地、年龄、性别、病理类型及HBV感染状况等信息。结果:1 729例肺肿瘤患者中男1 179例,女550例;肺癌患者1 474例,良性肿瘤228例,诊断不清的患者27例;95.72%的患者来自北方地区;肺癌患者中656例(44.50%)为腺癌,鳞癌和SCLC分别占33.24%和9.50%;68.29%的女肺癌患者为腺癌;良性肿瘤中最常见的为炎性肿块,共67例(29.39%);共55.29%(941/1 702)的肺肿瘤患者病变部位位于右肺,尤其是右肺上叶;肺肿瘤患者的HBV感染率相对稳定,为4.92%,且与病理类型无关。结论:肺肿瘤在男性患者中高发,病变部位最常见于右肺,尤其是右肺上叶,腺癌已经成为最常见的病理类型。     

Multiple primary malignant neoplasms: case report and a comprehensive review of the literature

A case is presented of an elderly patient with synchronous ureteral/bladder/urethral transitional cell carcinoma and prostatic adenocarcinoma. In a subsequent review of 1,104,269 cancer patients in the literature, the reported prevalence of multiple primary malignant neoplasms (MPMN) varies between 0.734% and 11.7%. It appears that MPMN might occur more frequently than can be explained on the basis of random chance. As expected, the incidence of developing MPMN is noted to rise with increasing age. In addition, the preponderance of men with MPMN is caused primarily by the high frequency of prostatic cancer. Current studies and research need to address the potential of older cancer patients being at higher risk of second primaries.     

Second primary cancers in patients with lung carcinoma.

BACKGROUND: There are only limited population-based data available regarding the risk of developing a second cancer after a diagnosis of lung carcinoma. METHODS: Data collected from the Cancer Registry of the Swiss Canton of Vaud (comprised of approximately 600,000 inhabitants) were used to estimate the incidence of a second metachronous primary cancer following a diagnosis of lung carcinoma. Between 1974 and 1996, 5794 cases of lung carcinoma (occurring in 4728 males and 1066 females) were followed actively until the end of 1996. RESULTS: One hundred seventy-five second primary neoplasms were registered (occurring in 146 males and 29 females). Significant excess rates were observed for all cancer sites (standardized incidence ratio [SIR] = 1.2), cancers of the oral cavity and pharynx (SIR = 2.7), and lung (SIR = 1.7). SIRs also were above unity for cancers of the esophagus (SIR = 1.8), pancreas (SIR = 1.5), bladder (SIR = 1.8), kidney (SIR = 2.3), and the female breast (SIR = 2.0). Excess rates for all cancer sites together and tobacco-related neoplasms were systematically higher at a younger age (< 60 years). The overall cumulative risk of lung cancer was 1.8% at 5 years and 4.7% at 10 years and was 5% and 11%, respectively, for any tobacco-related tumor. The estimates were consistent for squamous cell carcinoma and adenocarcinoma of the lung. CONCLUSIONS: There were substantial excesses of second lung carcinomas as well as other major tobacco-related neoplasms, but not of colorectal carcinoma, prostate carcinoma, or lymphoid neoplasms after the diagnosis of a primary lung carcinoma. This study emphasizes the importance of smoking cessation even after a diagnosis of lung carcinoma.     

2002年-2011年广西肿瘤医院6173例肝恶性肿瘤分析

目的:分析近十年来广西肿瘤医院肝恶性肿瘤患者的年龄、性别、民族及地区分布,病理类型情况和转归,以了解本地区肝恶性肿瘤发病趋势,为临床防治工作提供依据。 方法:按照国际疾病分类（ICD-10）肿瘤形态学及肝恶性肿瘤病理分类原则进行检索,收集我院2002年-2011年肝恶性肿瘤首次入院病例进行统计分析。结果:2011年首次入院人数比2002年增加78.6%。男女比7.14∶1,发病高峰年龄30-60岁,30岁以后发病率为94.5%。就诊患者多来自广西中南部地区,其中汉族和壮族就诊人数占98%以上。原发性肝癌占肝恶性肿瘤的97.7%,其它肝恶性肿瘤（如神经内分泌瘤、纤维肉瘤、血管肉瘤等）占2.3%。甲胎蛋白（AFP）阳性者为71.8%,HBsAg阳性率为80.4%,两者皆为阳性者62.8%,两者皆为阴性者10.6%。234例发生转移的恶性肿瘤中,肝内转移占35.0%、肺转移34.6%、骨转移9.4%、脑转移3.0%、周围淋巴结15.4%、其它2.6%。结论:近年来本地区肝恶性肿瘤患病人数快速增加,且男性远多于女性,各个年龄段均可发病,30岁以后为高发人群。本病好发于广西中南部地区,民族之间无差异。病理学分型主要以原发性肝细胞癌为主,混合性肝癌较少见。 HBsAg和 AFP与肝癌关系密切,且HBsAg和 AFP可能存在一定的相关性。十年来我院采用手术和联合治疗的方法,使肝恶性肿瘤的治愈率不断上升,死亡率逐年下降。     

Influence of family history, irradiation and anti-cancer drug (mitomycin C) on the occurrence of multiple primary neoplasms in breast carcinoma patients

The influence of family history, irradiation and anti-cancer drug (Mitomycin C) on the occurrence of multiple primary neoplasms was analysed using the person-year method in 1359 Japanese breast carcinoma patients. There were 111 multiple primary neoplasms, including bilateral breast cancer, in 109 patients; the incidence rate was 0.0072 per person-year. The incidence rate in patients with a family history of cancer was 1.29 times higher than in those without. In the bilateral breast cancer group there was about a 3 times higher frequency of family history of breast cancer. Irradiation therapy raised the occurrence of multiple primary neoplasms 1.28 fold, and Mitomycin C (40 mg) had no effect on the occurrence of neoplasms during a 10-year observation period.     

34例子宫内膜癌合并结直肠癌双原发癌的临床特征及其与Lynch 综合征关系分析

目的:探讨子宫内膜癌合并结直肠癌双原发癌患者的临床表现、治疗方法及其预后,并分析与Lynch 综合征关系。方法:回顾性分析中国医学科学院肿瘤医院34例子宫内膜癌合并结直肠癌双原发癌患者的临床病理资料。结果:34例患者的中位发病年龄为51.5（39~ 76）岁,64.7%（22/ 34）有肿瘤家族史,子宫内膜样腺癌占79.4%（27/ 34）。 34例中33例双原发癌患者行手术治疗,19例子宫内膜癌、17例结直肠癌术后行放化疗。2 年生存率为84.3% ,5 年生存率为63.1% 。结论:子宫内膜癌合并结直肠癌双原发癌患者多具有肿瘤家族史、发病年龄早、预后与散发型结直肠癌相近,部分患者符合Lynch 综合征。      

Second primary tumors after prostate carcinoma.

BACKGROUND: Several large datasets have shown a reduced risk of all neoplasms after a diagnosis of prostate carcinoma but an increased incidence rate of urologic carcinoma has been suggested. METHODS: Data collected by the Cancer Registries of the Swiss Cantons of Vaud and Neuchatel (approximately 760,000 inhabitants) were used to estimate the incidence rate of a second primary tumor after a diagnosis of prostate carcinoma. A total of 4503 cases registered between 1974 and 1994 were followed until the end of 1996 (17,065 person-years). RESULTS: A total of 380 second primary neoplasms were observed versus 534.1 expected primary neoplasms (standardized incidence ratio [SIR] = 0.7; 95% confidence interval, 0.6-0.8). SIRs were significantly below unity for lung carcinoma (SIR = 0.7) and other major tobacco-related neoplasms, including those of the mouth or pharynx (SIR = 0.5), esophagus (SIR = 0.4), pancreas (SIR = 0.5), and larynx (SIR = 0.8). There was no excess rate of subsequent urologic carcinoma (SIR = 1.0) or colorectal carcinoma (SIR = 0.9). The reduced SIRs for lung carcinoma were stronger in elderly men (age >/= 75 years) and in patients with a shorter period since diagnosis (< 5 years). CONCLUSIONS: The incidence of all neoplasms was reduced significantly in men diagnosed with prostate carcinoma. Selection of the population, under-registration of second primary tumors, and reduced surveillance in elderly men with prostate carcinoma may, at least in part, explain this reduction in risk. No excess risk was observed for the complex of urologic neoplasms nor for tobacco-related neoplasms. This finding would not support an association between cigarette smoking and prostate carcinoma.     

Multiple primary malignant neoplasms in breast cancer patients in Israel

The data of an epidemiologic study of multiple primary malignant neoplasms in breast cancer patients in Israel are presented. During the 18-year period of the study 12,302 cases of breast carcinoma were diagnosed, and, of these, 984 patients (8%) had multiple primary malignant tumors. Forty-seven of these patients developed two multiple primary cancers. A significantly higher than expected incidence of second primary cancers occurred at the following five sites: the opposite breast, salivary glands, uterine corpus, ovary, and thyroid. Cancers of the stomach and gallbladder were fewer than expected. Treatment of the breast cancer by irradiation was associated with an increased risk of subsequent cancers of lung and hematopoietic system. The prognosis was mainly influenced by the site and malignancy of the second primary cancer. The incidence of multiple primary malignancies justifies a high level of alertness to this possibility in the follow-up of breast cancer patients.     

Second neoplasms after Wilms' tumor in childhood

The frequency of second neoplasms was examined among 487 Wilms' tumor patients treated at the Dana-Farber Cancer Institute and Children's Hospital of Boston, 1927-81. Thirty study patients (6%) developed second primary tumors: 11 cancers, 16 benign tumors, and 3 borderline neoplasms. Cumulative probability of a second cancer was 18% (standard error, 6%) in 34 years after diagnosis of Wilms' tumor. The subgroup of 412 patients who had received radiotherapy for Wilms' tumor developed all 11 second cancers, which included 1 skin carcinoma, 1 acute leukemia, and 9 solid internal cancers (expected, 0.7 cancers other than skin carcinoma; P less than .001). After exclusion of the secondary leukemia, all but 1 second cancer arose within the radiotherapy field. Concurrent therapy with dactinomycin did not reduce the risk of a radiation-associated cancer. Second cancer was the cause of death in 7 patients.