泌尿生殖系多原发恶性肿瘤15例报告

目的：探讨泌尿生殖系多原发恶性肿瘤（MPN）的相关问题。方法：对15例泌尿生殖系MPN患者临床资料进行回顾性分析，并结合文献复习就其诊断标准、发病情况、发病因素及预后进行了讨论。结果：第2癌切除术后生存1．5年者1例，2年者1例，3年以上者2例，5年者2例。结论：MPN的预后与转移癌不一样，鉴别多发癌是多原发癌还是转移癌具有重要的临床意义。     

泌尿男生殖系多原发恶性肿瘤(附22例报告)

目的　探讨泌尿男生殖系多原发恶性肿瘤的发病率及预后。　方法　回顾性分析近 8年收治的 2 2例多原发恶性肿瘤的发病率、第 1及第 2恶性肿瘤间隔时间及预后。　结果　泌尿男生殖系多原发恶性肿瘤占同期收治的泌尿男生殖系恶性肿瘤的 3 .2 % ,7例同时发病者存活时间平均 15个月 ;异时发生 15例中 3例存活 7个月～ 5年 ,12例在第 2癌治疗后 8个月至 15年仍存活。　结论　泌尿男生殖系多原发恶性肿瘤近年有增加趋势 ,第 1癌治疗后应密切随访 ,及早发现和正确治疗第 2原发癌是延长生存期的关键     

与泌尿及男生殖系相关的多原发恶性肿瘤

多原发恶性肿瘤 (multipleprimarymalignantneoplasms,MPMNs)是一种特殊的肿瘤表现形式 ,自 1 889年Billroth首次报道以来不断有学者对此进行研究。在临床上 ,MPMNs易与恶性肿瘤晚期转移相混淆 ,造成误诊、误治。为提高对它的认识 ,现将与泌尿男生殖系相关的MPMNs综述如下。1 　MPMNs的定义MPMNs是指宿主同时或先后发生两个及两个以上原发恶性肿瘤。按两个肿瘤发现的时间间隔可分为同时性和异时性两种 ,多将间隔 6个月及以内者归为同时性 ,超过 6个月者归为异时性。2 　 流行病学MPMNs的发生率无国家级统计资料 ,文献中报道的均为…     

多原发恶性肿瘤五例报告

多原发恶性肿瘤(multiple primary malignant neoplasms,MPMNs)是指同一宿主的单个或多个器官同时或先后发生2种或2种以上的原发恶性肿瘤,随着人们认识的提高及医疗条件的改善,MPMNs有增多趋势,其相关报道亦日渐增多[1],从二重癌到六重癌都有报道,但以二重癌多见,三重及以上相对少见.我院普外科2007年1月至2011年10月收治多原发恶性肿瘤5例,现报告如下.     

泌尿男生殖系多原发恶性肿瘤(附39例报告)

目的 探讨泌尿男生殖系多原发恶性肿瘤的临床特点。方法 对１９７２年１月～１９９８年１２月收治的３９例多原发恶性肿瘤患者的临床资料进行回顾性分析。结果 本组多原发恶性肿瘤的发生率为５．０％，平均发病年龄６５岁（第一癌），第一癌与第二癌平均间隔３．７年。３４例随访０．３～１６．５年，平均６．４年。１９例死亡，直接死因为第二癌者１６例。结论 多原发恶性肿瘤在泌尿外科并不少见，对第二癌的诊疗应引起重视。     

膀胱癌患者发生第二原发恶性肿瘤的预后分析——一项基于人群的研究

目的 分析膀胱癌患者出现第二原发恶性肿瘤的发生率和预后。方法 从美国国立癌症研究所建立的监测、流行病学和最终结局项目数据库(The Surveillance,Epidemiology,and End Results,SEER)中提取2005～2014年以膀胱癌为首发恶性肿瘤的患者资料,利用Fine和Gray竞争风险模型分别计算了泌尿生殖系第二原发恶性肿瘤和非泌尿生殖系第二原发恶性肿瘤的累积发生率,利用倾向评分匹配方法平衡组间基线特征,利用Kaplan-Meier法分析了有无第二原发恶性肿瘤的膀胱癌患者的总体生存率及不同种类的第二原发恶性肿瘤的预后情况。同时分析了第二原发恶性肿瘤手术对于患者总体生存率的影响。结果 在150个月随访期内,膀胱癌患者后续出现泌尿生殖系和非泌尿生殖系第二原发恶性肿瘤的累积发病率分别为0.67%和12.58%。前列腺、肺和支气管是最常见的第二原发恶性肿瘤发生部位。伴有和不伴有第二原发恶性肿瘤的膀胱癌患者10年生存率分别为43.10%和55.50%。膀胱癌后续出现前列腺癌及皮肤黑色素瘤患者中位生存时间分别为163个月和167个月,而单纯膀胱癌患者中位生存时间分别为...     

泌尿生殖系相关的多原发癌11例报告

报告１９８５－１９９５年间诊治的与泌尿生殖系相关的多原发癌１１例，并结合文献重点强调多原发癌有别于晚期转移癌，它是人体内同时或异时存在的两种两种以上各自独立的原发癌。认为如能及早积极手术治疗并辅以其他疗法，其预后不比单比癌差。     

泌尿生殖系多原发性恶性肿瘤20例

多原发性恶性肿瘤 (multiple primarymalignant tumors,MPMT)国内外近年常有报道 ,但发生在泌尿生殖系的 MPMT报道甚少。我院1 963年 9月～ 1 998年 1 0月共收治泌尿生殖系恶性肿瘤 1 1 56例 ,其中 MPMT 2 0例 ,报告如下。1　临床资料本组 2 0例 ,男 1 5例 ,女 5例 ,男∶女为 3     

脾转移癌3例报道及相关文献回顾

目的：报道3例脾转移癌病例，并探讨脾转移癌的诊断、治疗及预后。方法：报道本院3例脾转移癌病例，并系统分析相关文献。结果：脾转移癌可发生于多种恶性肿瘤；影像学检查是最常用的检查方法；孤立脾转移灶可手术，综合治疗根据原发肿瘤而定；预后与原发肿瘤性质关系密切。结论：临床上应对癌症脾转移给予重视。     

泌尿生殖系癌的自然消退——最新观点

泌尿生殖系癌,由于较高而准以解释的自然消退发生率,引起广泛的兴趣。Everson和Cole给自然消退下的定义是:“恶性肿瘤在完全没有治疗或只有认为不当的治疗下,出现的部分或完全消失。可分为6种类型: 1.原发肿瘤消失, 2.经组织学证实的转移灶消失, 3.未经组织学证实的转移灶消失, 4.只经放射学推定的肿瘤的消失, 5.肿瘤长期被抑制, 6.延期的转移或复发。后二类型对泌尿外科医生尤其有兴趣。许多泌尿生殖器肿瘤,特别象肾腺癌,前列腺腺癌,其生物学     

三个癌瘤以上的多原发恶性肿瘤

目的：探讨3个癌瘤以上的多原发恶性肿瘤（MPMNs）的流行病学和临床特点。方法：回顾性分析1958年-2001年收治的125例患者的发病率、发病年龄、性别比、间隔时间、好发部位。结果：3个癌瘤以上的MPMNs的发病率为0.090％,其中3、4、5MPMNs的发病率分别为0.078％、0.009％和0.001％;平均发病年龄为64岁。男：女为1.0：1.2。平均间隔时间为7.1年,第1和2、2和3、3和4、4和5原发癌的间隔时间渐短,从5、7减至2.4年。3年内为相邻两癌的高发时间。好发部位：按单一器官计3个癌瘤原发癌依次为：大肠、乳腺、肺、食管、子宫和皮肤;4个癌瘤原发癌为：大肠、乳腺、皮肤、胃、子宫和膀胱;5个癌瘤原发癌为：大肠、乳腺、皮肤、腮腺。结论：3个癌瘤以上的MPMNs的发生率有增多的倾向;发病年龄在逐渐增大;女性多于男性;第1和2、2和3、3和4、4和5原发癌的时间间隔逐渐缩短;好发器官为同一器官,成对器官和同系统的器官。     

剪切波弹性成像在乳腺良恶性病变中的应用进展

乳腺癌发病率逐年上升,且趋于年轻化。鉴别乳腺良恶性病变是预防、诊断及治疗乳腺癌的重点。剪切波弹性成像是一项新的超声定量技术,已在乳腺、甲状腺、腮腺、睾丸等组织病变呈现出重要临床应用价值。本文就剪切波弹性成像对鉴别诊断乳腺良恶性病变的应用进展进行综述。     

遗传性非从病性大肠癌24家系的临床特点和诊治

目的　回顾性调查遗传性非息肉病性大肠癌 2 4家系的诊断、治疗经验。方法　对 2 4个遗传性非息肉病性大肠癌家系的诊断、治疗和随访进行回顾性调查 ,分析恶性肿瘤部位、诊断年龄、癌的病理学资料和处理策略。结果　恶性肿瘤在家族中呈常染色体显性遗传 ,2 4个家系中共有患者75名 (多原发癌 2 4名 ) ,共诊断各种恶性肿瘤 12 5个 ,主要有结肠癌 6 3个、直肠癌 2 1个、胃癌 13个、子宫内膜癌 7个、食道癌 6个。患者平均发病年龄 5 1岁 ,较大家系的患者均存在发病年龄逐代提前现象。 2 4 %的大肠癌患者首次手术 10年内再发异时性大肠癌。结论　本病是典型的常染色体显性肿瘤遗传病 ,主要特点包括大肠癌尤其是右侧结肠癌多见 ,多原发癌多见 ;子宫内膜癌、胃癌、食道癌等也是本病的常见肿瘤 ;患者肿瘤发生早并呈发病年龄逐代提前的现象 ;常规肠段切除手术不适于本病大肠癌的治疗 ;对术后患者和可能的突变基因携带者应积极随访     

Primary nonlymphoreticular malignant neoplasms of the spleen

Primary sarcomas of the spleen are exceedingly uncommon neoplasms, approximately 90 substantiated cases having been reported. We report on six cases of primary splenic angiosarcoma and three cases of primary malignant fibrous histiocytoma of the spleen which have been seen at the Mayo Clinic during the last 51 years. In one of the cases of splenic angiosarcoma, the lesion was manifested by spontaneous rupture and hemoperitoneum; interestingly, two cases of splenic malignant fibrous histiocytoma were of the inflammatory type and showed corresponding clinical features of a systemic nature. Five patients with angiosarcoma of the spleen died of metastatic tumor within 3 years after diagnosis; one patient with splenic malignant fibrous histiocytoma is alive with metastasis 11/2 years after splenectomy. One case of splenic angiosarcoma and two of malignant fibrous histiocytoma of the spleen have been diagnosed only recently. All three patients are alive and currently tumor-free, from 3 to 7 months after diagnosis.     

Fine needle aspiration in the diagnosis of salivary gland lesions

Fine needle aspiration biopsy (FNAB) of salivary glands was performed in 187 patients. In 106 patients with satisfactory FNAB smears who proceeded to surgery, the original cytologic diagnosis was compared with subsequent histopathology. There were 74 benign tumours and 25 malignant tumours. Nineteen of the latter were primary malignant neoplasms of the salivary glands, and 6 were metastatic. The cytologic diagnosis by FNAB correlated exactly with the histologic diagnosis in 95% of benign neoplasms and in 68% of malignant neoplasms, with an overall accuracy of 88%. A false negative diagnosis for malignancy was made in five cases and a false positive diagnosis in one case. Hence the sensitivity for malignancy was 80% and the specificity was 99%. The most frequently misdiagnosed lesions were pleomorphic adenoma and muco-epidermoid carcinoma. FNAB of salivary gland lesions is easy to perform and free of complications, but the cytologic patterns may be difficult to interpret, and considerable experience is necessary in order to achieve a high diagnostic accuracy.     

Malignant peripheral primitive neuroectodermal tumor-peripheral neuroepithelioma of the head and neck: a clinicopathologic study of five cases and review of the literature

BACKGROUND: The term primitive neuroectodermal tumor (PNET) encompasses a number of neoplasms of common neuroectodermal origin, but of variable clinical, histopathologic, ultrastructural, and molecular characteristics. Here, we focus on one particular member of the PNET family, the malignant peripheral PNET (pPNET) or peripheral neuroepithelioma of head and neck. METHODS: Five patients diagnosed with malignant pPNET-peripheral neuroepithelioma of head and neck were included in the study. All existing literature was reviewed. RESULTS: The diagnosis of malignant pPNET-peripheral neuroepithelioma of the head and neck was confirmed in all five cases. All patients are alive after treatment with a combination of therapeutic modalities; only one patient had metastatic disease develop. A literature review revealed another 38 reported cases. CONCLUSIONS: Malignant pPNET-peripheral neuroepithelioma should be included in the differential diagnosis of small, round, blue cell tumors of head and neck. A combination of multiple diagnostic modalities is essential for correct diagnosis, and multimodality treatment offers the best outcome.     

纵隔镜检查术165例临床分析

目的 探讨纵隔镜检查术在胸部疾病诊断及确定手术适应证中的价值。方法 对1979－2000年,有选择性地施行纵隔镜检查术的165例患者的临床资料进行回顾性分析。所有患者皆采用局部浸润麻醉（个别病例加用静脉基础麻醉）下,经气管前间隙向下方探查气管周围肿物和淋巴结,并进行活检。结果 有125例诊断符合（11例未能明确诊断和8例肺癌患者虽纵隔镜检查阴性但未经手术证实不计入）,21例诊断不符合。诊断符合率为85．6％（125／146）。其中20例纵隔淋巴结阳性的肺癌患者和7例经纵隔镜诊断恶性淋巴瘤者避免了开胸手术。结论 纵隔镜检查术,对累及纵隔淋巴结的疾病或紧邻纵隔的胸部疾病是一种有效的检查方法,对于诊断不明的单纯纵隔淋巴结肿大者尤其适合。对肺癌伴有纵隔淋巴结肿大或纵隔肿瘤者可选择应用。     

Prognostically favorable "mitotically active" smooth-muscle tumors of the uterus. A clinicopathologic study of ten cases

We evaluated the clinicopathologic features of 22 smooth-muscle tumors of the uterine corpus that had at least five mitoses per 10 high-power fields (HPF) in the most active areas. Ten women were alive and well without tumor recurrence 15 months to 11 years after diagnosis (median, 6 years); these patients were referred to as the "clinically benign" group. The other 12 women had "clinically malignant" disease: 9 died of recurrent or metastatic tumor 3 months to 4.5 years after diagnosis (median, 16 months), and 3 are alive with disease 4-12 months after diagnosis. Significant clinical and pathologic differences were observed between patients in the "benign" and "malignant" groups. We found that mitotic activity in the range of 5 to 15 mitoses per 10 HPF was not a reliable predictor of aggressive behavior in tumors that lacked marked cytologic atypia and that by all other clinical and pathologic criteria were leiomyomas. An unfavorable prognosis among the mitotically active neoplasms could be predicted by a constellation of clinicopathologic features, including postmenopausal status, a clinical or intraoperative impression of cancer by the surgeon, extension of tumor beyond the uterine corpus, size greater than 10 cm, marked cytologic atypia, invasive borders, necrosis, and mitotic counts exceeding 20 per 10 HPF.