多原发恶性肿瘤合并口腔病变的临床研究

目的 探讨多原发恶性肿瘤患者合并的口腔颌面部恶性肿瘤的临床特点和诊治原则。方法 收集21例合并口腔颌面部恶性肿瘤的多原发恶性肿瘤患者，对其临床资料进行回顾性分析。结果 21例患者共发生44个恶性肿瘤，其中24个位于消化道及呼吸道，10个位于涎腺、乳腺及女性生殖系统，其他10个发生于头皮、耳前区皮肤、甲状腺、膀胱及血液系统。发生于口腔颌面部的恶性肿瘤共25个，主要的病理类型是鳞状细胞癌，其次是腺样囊性癌；常见的发生部位是舌，其次是腮腺、颌下腺、颊黏膜及牙龈。结论 在口腔颌面部，舌及涎腺是多原发恶性肿瘤的好发部位，与消化道、呼吸道密切相关，应对患者进行长期的认真的随访；对于女性患者，乳腺及生殖系统应是检查的重点。定期随访、早发现、早诊断及积极有效的治疗有助于提高患者生存质量。

Clinical Study of Oral and Maxillofacial Malignancies Associated with Multiple Primary Malignant Neoplasms

Objective To study the clinical characteristics, diagnosis and treatment strategy of oral and maxillo- facial malignancies in multiple primary malignant neoplasm(s MPMNs). Methods 21 cases of oral and maxillofacial malignancies associated with MPMNs admitted to our hospital between 1985 and 2000 were studied respectively. Results There were 44 malignant cases in the 21 MPMNs patients. Among the 44 cases, there were 24 cases in alimentary and respiratory tractsuch as oral, pharynx, esophagus, stomach and lung, and 10 cases in salivary gland, breast and female reproductive system. There were 25 cases malignant neoplasms in oral and maxillofacial region where squamous cell carcinoma was the most common pathologic type, secondly adenoid cystic carcinoma. In oral and maxillofacial region, MPMNs were often found in tongue, parotid and submandibular gland, buccal mucosa and gingival. Conclusion Tongue and salivary gland were the common locations with MPMNs, and they were closely associated with alimentary and respiratory tract. Patients with malignancies of oral and maxillofacial region associated with MPMNs must be submitted to a long- term and careful follow- up. For female patients, breast and female repro- ductive system should be examined specially. Regular follow- up, early detection, early diagnosis, active and effective treatment can help to improve the survival quality of MPMNs patients.