34例与肺癌相关的多原发癌的临床分析

目的:探讨与肺癌相关的多原发癌的临床特点。方法:回顾性分析34例与肺癌相关的多原发癌患者的临床病历资料。结果:34例患者中,同时癌占38%(13/34),异时癌占62%(21/34)。在多原发癌中肺癌起病隐匿,首发症状以咳嗽、咯血、胸闷气促常见,无症状者16例。肺癌病理分型以腺癌最为常见。再罹患肺癌风险更高的是头颈部肿瘤,肺癌患者最易再罹患消化系统肿瘤。重癌切除率67.6%。第一原发癌中位生存期为4.5年,第二原发癌中位生存期为1年。多原发癌中肺癌发生的先后顺序与预后无明显相关性。结论:与肺癌相关的多原发癌有一定的临床特点,预后较好,应重视初诊肿瘤患者的随诊工作,早期发现,积极治疗,提高患者生存率。

Clinical analysis of 34 cases with multiple primary cancer associated with lung cancer

Objective： To study the clinical characteristics of multiple primary cancers（MPC） associated with lung cancer. Methods： Clinical data of 34 cases with MPC associated with lung cancer were analyzed retrospectively. Results： The synchronous MPC comprised 38% （ 13/34）, the metachronous MPC accounted for 62% （21/34）. The onset of lung cancer in MPC was concealed, the initial symptoms of the cases were cough, hemoptysis, chest distress and shortness of breath, 16 cases were discovered by health examination without any symptom. Adenocarcinoma was the most common in those pulmonary lesions. Patients with head and neck cancers ran a higher risk of developing second primary lung cancer. Patients who had lung cancer were most frequently occurred with other primary cancer in digestive system. The resection rate of MPC was 67.6%. The median survival time was 4.5 years for the first cancer, and 1 year for the second cancer. There was no signifi- cant correlation between the sequence of occurrence and prognosis for lung cancer in MPC. Conclusions： MPC associated with lung cancer has its clinical characteristics, and the prognosis is relatively weU. We should pay more attention to regular follow-up than before. Early diagnosis and detection, active and effective treatment can help to improve the life quality of MPC patients.