c—erbB—2,p53,p21基因表达与胃癌及大肠癌预后因素的关系

应用ＡＢＣ免疫组织化学染色方法检测１２０例胃癌和大肠癌的癌肿内及转移淋巴结中ｃ－ｅｒｂＢ－２、ｐ５３、ｐ２１基因的过度表达。多基因阳性在胃癌中占６６．７％；大肠癌中占６８．３％，多基因表达明显提示胃癌及大肠癌预后差。单基因阳性亦分别显示胃癌及大肠癌预后较差。转移淋巴结与胃癌及大肠癌的原发癌肿之间基因过度表达与否的平均符合率ｃ－ｅｒｂＢ－２为８３．１％；ｐ５３为７５．３％；ｐ２１为７７．９％，表明转移淋巴结中的基因过度表达与否与原发癌肿相似。ｃ－ｅｒｂＢ－２、ｐ５３、ｐ２１的多基因表达的检测对胃癌和大肠癌的预后判断明显优于其中某个单基因表达的检测。不同单基因表达有关的后因素在同一癌肿中均不一致同一基因表达不同癌肿中的有关预后因素亦不一致     

胃肠癌多原发癌的及时诊断和治疗

在１１４１例胃肠癌中发现多原发癌３１例（占２．７２％），其中同时型９例，异时型２２例，双重癌２６例、三重癌４例，四重癌１例，发病年龄２１岁－８１岁，中位间隔时间２年９个月，重视高危人群手术前的全面检查，术中仔细探寻，正规操作，必要时行术中纤维镜检查，以及术后定期作胃肠镜检查是提高胃肠多原发癌检出率的重要因素，对于胃肠多原发癌应力求根治，以利提高疗效。     

食管多原发癌淋巴转移初探

多原发恶性肿瘤少见,食管多原发癌更少见。食管多原发癌淋巴结转移规律少见报道。自１９８６年９月至１９９６年１２月,本科收治食管多原发癌２０例,占同期收治食管癌患者２．３％。本文进行回顾性分析,着重探讨其淋巴结转移特点。１材料与方法２０例食管多原发癌中,...     

鼻咽癌与多发癌160例临床分析

本文报告１９６３年３月－１９９１年８月我院诊治的鼻咽癌合并多发癌１６０例，其中鼻咽癌放疗后并发其他原发癌瘤者１１４例（第一组）；与鼻咽癌同时发生或其他原发癌治疗后发生鼻咽癌者４６例（第二组）。第一组患鼻咽癌时作根治性放疗；第二组发生另一原发癌前从未接受过放疗。结果为第一组另一原发癌发生于头颈部者８０例，占６９．０％。其它部位者３６例，占３１．０％；第二组则分别为３６．２％和６３．８％，差别显著。我     

多发性原发性食管癌及食管贲门双原发癌的诊断和治疗

为提高多发性食管癌及食管贲门双原发癌的诊断率及生存率，本文对６５８例食管癌手术治疗患者的资料作回顾性分析。其中多发性原发性食管癌１９例，占２．９％。食管贲门双原发癌２例，占０．３％。作者认为，要提高本病的诊断率，应切实做好以下工作：①完善的食管吞钡造影；②纤维胃镜下可疑部位的多点活组织检查；③胃超声检查；④多次分段食管拉网检查；⑤术中细致的外科探查；⑥术后连续病理切片检查。提示：早期诊断和及时手术     

双原发癌156例临床分析

为了探索多原发癌的发病机制和施予恰当的治疗，作者对１９８２～１９８７年间中山医科大学附属肿瘤医院院收治的１５６例双原发癌进行回顾性研究。本组病例占同期收治的全部恶性肿瘤的０．５％，其中男８６例，女７０例，年龄１７～８０岁，中位数５０岁。３４例为同时发生，１２２例为异时发生。鼻咽、肺、大肠及乳腺是多原发癌较为常见的发病部位。治疗原则与普通原发癌一样，本组５年生存率为３４．６％，高于国内一般水平。提示我们必须提高对多原发癌的认识，及时、正确地作出诊断，并采取积极的、有别于复发癌的治疗。     

多原发癌组织中p53 表达状况研究

 目的 研究多原发癌组织中的p53蛋白表达状况，探讨抑癌基因p53在多原发癌的发生、发展中的意义。方法 应用免疫组织化学方法检测21例双原发癌组织中的p53蛋白表达。结果 21例患者中，第一癌和第二癌p53均阳性者9例(42．85％，9／21)，仅一次p53阳性者9例(42．85％，9／21)，两次均阴性者3例(14．12％，3／21)。结论 抑癌基因p53在多原发癌的发生、发展中可能起重要作用，对这些发现的意义值得进一步研究。     

原发性四重癌1例分析

多原发癌是指2个或2个以上器官发生的原发性恶性肿瘤，发病率尸检为1．2～5．7％，临床报告为0．59～2．45％。随着肿瘤诊断技术的不断提高，近年来发病率在不断上升，多原发癌中以双原发癌为多见，对于原发性四重癌的发生较为罕见。现报告如下：     

食管胃双原发癌临床病理分析

目的：探讨食管胃双原发癌临床病理特征、治疗及预后，提高临床诊治的警惕性和重视程度。方法：收集我院食管胃双原发癌24例，并结合文献资料进行临床病理特征分析。结果：食管胃双原发癌占同期标本1．69％。男性居多，60岁左右好发。食管以中段居多。鳞癌为主，胃以贲门居多。腺癌为主，双原发癌与癌症多中心起源有关。结论：男性中老年患者。出现上消化道症状时，要警惕双原发癌可能。     

多原发性大肠癌

大肠癌的发病率和死亡率已居我国各地区恶性肿瘤的第4～8位，目前呈持续增加趋势。癌肿病人患多原发癌不多，国内文献报道发生率仅为0．43～0．65％，但大肠癌病人发生多原发性癌却较常见，它可位于大场或大肠以外的其它器官．现将我科大肠癌病人的多原发癌报告如下。临床资料我科1972年1月～1994年12月收治大肠癌病人756例，其中多原发癌28例，占同时期大肠癌的4．3％。男性15例，女性13例；年龄33岁～76岁，中位年龄54岁。1．同时多原发大肠癌本组5例，占同期大肠癌的0．77％。同时发现两个病灶1例，3个以上痛灶4例，共16个癌灶。多个癌灶…     

女性生殖器重复癌20例临床分析

目的　探讨女性生殖器重复癌的病因、诊断及治疗。方法　采用回顾性分析方法对 2 0例女性生殖器重复癌进行分析。结果　双重复癌三年生存率为 43 .8% ,五年生存率为 18.8%。 3例三重癌患者 ,均在第三重复癌出现后 2年内死亡。结论　术前应完善检查 ,术后应定期复查 ,及早发现 ,积极治疗 ,以延长患者的生存期。     

120例多原发肿瘤临床分析

 目的 探讨多原发肿瘤的病因、临床特点、治疗及预后。方法 采集北京中医药大学东直门医院120例多原发肿瘤患者病历资料，对其进行回顾性分层分析。结果 （1）男女比例相近；（2）发病年龄为26~89岁，中位年龄58岁；（3）双原发恶性肿瘤116例，三原发恶性肿瘤2例，四原发恶性肿瘤1例，五原发恶性肿瘤1例；（4）同时性多原发肿瘤25例，异时性多原发肿瘤95例，发病间隔时间6~444月，中位间隔时间32月；（5）首发恶性肿瘤以消化系统最多，第二原发恶性肿瘤以血液系统居多；（6）3年和5年生存率分别为48.3%和37.5%。结论 通过临床分析提高对多原发肿瘤的认识，指导临床早发现、早诊断及早治疗，以期延长患者生存期，改善预后。     

肺癌患者的多原发恶性肿瘤

目的：总结肺癌患者多原发恶性肿瘤的诊断和治疗经验。方法：分析肺癌患者多原发恶性肿瘤４５例的临床病理资料,占同期手术病理证实１８３６例肺癌的２．５％。男３８例,女７例。多原发肺癌１６例,占０．９％,其中１５例为双原发癌,１例为三原发癌;肺癌与其他脏器恶性肿瘤２９例,占１．６％,其中２７例为双原发恶性肿瘤,２ 三原发癌。结果：多原发肺癌患者术后３和５年生存率为６０．０％（６／１０）和４４．４％（４／９     

A multicenter study of primary brain tumor incidence in Australia (2000-2008)

There are conflicting reports from Europe and North America regarding trends in the incidence of primary brain tumor, whereas the incidence of primary brain tumors in Australia is currently unknown. We aimed to determine the incidence in Australia with age-, sex-, and benign-versus-malignant histology-specific analyses. A multicenter study was performed in the state of New South Wales (NSW) and the Australian Capital Territory (ACT), which has a combined population of >7 million with >97% rate of population retention for medical care. We retrospectively mined pathology databases servicing neurosurgical centers in NSW and ACT for histologically confirmed primary brain tumors diagnosed from January 2000 through December 2008. Data were weighted for patient outflow and data completeness. Incidence rates were age standardized and trends analyzed using joinpoint analysis. A weighted total of 7651 primary brain tumors were analyzed. The overall US-standardized incidence of primary brain tumors was 11.3 cases 100 000 person-years (±0.13; 95% confidence interval, 9.8-12.3) during the study period with no significant linear increase. A significant increase in primary malignant brain tumors from 2000 to 2008 was observed; this appears to be largely due to an increase in malignant tumor incidence in the ≥65-year age group. This collection represents the most contemporary data on primary brain tumor incidence in Australia. Whether the observed increase in malignant primary brain tumors, particularly in persons aged ≥65 years, is due to improved detection, diagnosis, and care delivery or a true change in incidence remains undetermined. We recommend a direct, uniform, and centralized approach to monitoring primary brain tumor incidence that can be independent of multiple interstate cancer registries.     

多原发性恶性肿瘤

本文报告1975年5月至1990年12月发现的21例多原发癌,其中同时性2例,异时性19例。多原发癌的发生率逐年有增高趋势,因此当肿瘤病人出现另一个肿瘤时,不能轻易认为是转移或复发性肿瘤。多原发癌应予以根治。对于放射线诱发的肿瘤首选疗法是手术。患者预后与第二癌发生的部位、病理学类型、期别、治疗措施及两种癌发生的间隔时间有关。     

Multiple Primary Malignant Tumors in a National Cancer Registry: Reliability of Reporting

During the years 1958-1988, 808 522 individuals were registered in the Swedish national population-based cancer register with a total of 933 900 primary malignant tumors. Roughly 11% of the tumors reported to the Swedish Cancer Registry in 1988 were found in persons earlier registered for another primary malignancy. One hundred of the individuals registered with multiple primary malignant tumors were randomly selected for a study of the reliability of reporting of multiple malignancies. Medical records and—when necessary—histopathological slides and other relevant diagnostic material for each malignancy were collected and the diagnoses reevaluated. Three persons had to be excluded; thus 97 cases with 209 reported malignancies were analysed. Of these, 94% of the first, 98% of the second and 79% of the third malignancy were accepted. Twelve of the reported tumors were not accepted as malignant, five were benign or cancer in situ, five were incorrectly reported as new primaries and two were a second incorrect registration of a previously registered malignancy. All 97 persons had at least one malignant tumor, in 90% of the persons all reported diagnoses were accepted and 93% had multiple primary malignancies. The results of this quality control study indicate that suitable data are available in the Swedish Cancer Registry for investigations related to the occurrence of multiple primary malignancies in a large unselected population. The Swedish Cancer Registry, to which all newly diagnosed malignancies by law have to be reported, comprise today close to one million individuals with registered malignancies.     

A statistical analysis of multiple primary malignant tumors

The authors analyzed 32 patients with multiple primary malignant tumors treated in the Department of Otolaryngology, Mie Univ. from 1965 to 1984 and reviewed the literature. Of 1149 malignant head and neck tumors in our clinic in the same period, 32 cases (2.79%) were multiple primary malignant tumors. In this series, quadruple and triple malignancies were found in one case each and double ones in the others. The average age of these 32 patients was 67.5 years for the men and 52.7 for the women. The male: female ratio was 4.3:1. The average interval between the first and second tumor was 35 months, and in 17 cases (56.7%), they were synchronous. Laryngeal cancers were the most frequent double-primary lesions and cancers in the head and neck were most commonly associated with stomach cancers in this study.     

Analysis of multiple primary malignant tumors including lung cancer

In our hospital, from 1984 to 1986, we have performed autopsies on 50 lung cancer cases. Ten (20%) cases were found to have multiple primary malignant tumors, ie. one quadruple, 2 triple, 7 double malignant tumors, and almost all cases with multiple primary malignancies were males more than 70 years old. A histological examination showed that seven of these had tumors of the squamous cell type. In six cases, lung cancer was the primary disease and in 5 cases both malignancies existed simultaneously. When we lysed 5 g of autopsied lung, we were able to detect more than 100 asbestos bodies in 9 cases out of ten. Further, we noticed that triple or quadruple cases showed more asbestos bodies. Thus, we suspect that nearly all cases had been affected by exposure to asbestos.     

103例老年妇女妇科恶性肿瘤手术治疗分析

本文回顾了103例65岁以上老年妇女妇科恶性肿瘤的手术治疗，就术前合并症、手术范围、麻醉、手术切除率和术后并发症等问题进行了分析。结果表明，如果无重要脏器的严重合并症，老年患者仍能较好地耐受较大的手术。我们认为，只要处理恰当，老年患者的手术治疗是安全的，年龄大不应被视为手术禁忌证，对老年恶性肿瘤患者的手术治疗仍应持积极态度。