原发灶不明的淋巴结转移癌的治疗和预后（附31例报告）

目的 分析原发灶不明的淋巴结转移癌的临床特点，探讨其治疗方法及预后。方法回顾性分析我院2002年1月至2008年1月收治的31例原发灶不明的淋巴结转移癌患者的临床资料。结果全组的中位生存期为0．94年（0．28，6．20年）。单因素分析结果显示．分期、LDH、WBC、NSE和腺癌相关肿瘤标志物增高是预后不良的相关因素（P〈0．05）．根据这些预后不良因素建立预后指数评分，0分、1-2分、≥3分患者的1年生存率分别为100．00％、53．72％和16．67％（x^2=18．98，P=0．0001）。化疗后评价为部分缓解、稳定、进展患者的1年生存率分别为82．96％、41．67％和25．00％（X^2=6．21，P=0．0448）。结论原发灶不明的淋巴结转移癌患者的预后较差，根据预后影响因素建立预后评分可以预测患者的预后。提高化疗的疗效是改善预后的重要手段。

The prognosis and management in patients with metastatic carcinoma of lymph nodes from unknown primary (report of 31 cases)

Objective To analyze the clinical characteristics, prognosis and management in patients with metastatic carcinoma of lymph nodes from unknown primary site. Methods The data of 31 patients with lymph nodes metastastic carcinoma of unknown primary site between January 2002 and January 2008 were reviewed. Results The median overall survival was 0.94 years （0.28- 6.20 years）. By univariate analysis, increased stage, LDH, WBC, NSE and adenocarcinoma-associated tumor maker were poor-prognostic factors （P 〈 0.05）. According to these prognosis factors , prognostic index was built, the one-year survival rates of patients with 0, 1-2, 〉3 were 100.00%, 53.72% and 16.67%（x^2= 18.98, P = 0.0001） The one-year survival rates of patients with partial response, stable condition and progression condition after first-line chemotherapy were 82.96%, 41.67% and 25.00 %（x^2=6.21, P = 0.0448）. Conclusions The prognosis of the patients with metastatic carcinoma of lymph nodes from unknown primary site is poor. Prognostic index built according to poor-prognostic facters can predict the prognosis of the patients. Enhancing the effects is the important management of improving the prognosis of the patients.