下咽癌和喉癌的多重癌

对下咽，喉鳞癌患者的多重癌实况进行回顾性调查。方法 对１９８０年－１９９５年１６年间头颈部外科受诊者下咽癌１２５例，喉癌１８４例进行了分析，其中男２７６例，女３３例。结果３０９例患者中７９例发生多重癌。多重癌发生部位共１０１处，其中１７例三重癌，１例四重癌，的多重癌以食管癌和胃癌居多；喉癌，尤以声门型喉癌的多重癌以肺癌为主，声门上型喉癌的口咽，食管和胃多重癌的发生率较声门型喉癌为高。

Multiple primary cancers in patients with hypopharyngeal and laryngeal carcinomas]

OBJECTIVE: To investigate into the incidence of the multiple primary cancers in patients with hypopharyngeal and laryngeal carcinomas retrospectively. METHODS: Records of 309 patients with squamous cell carcinomas of hypopharynx and larynx during a 16 year period between 1980 and 1995 were reviewed. RESULTS: A total of 101(32.7%) second primary cancers were found in 79(25.6%) patients. Among them, 76(75.3%) second primary cancers were found in the aerodigestive tract. Patients with hypopharyngeal cancer showed higher incidence of second esophageal (23/55, 41.8%) and gastric (12/55, 21.9%) carcinomas than those with laryngeal cancers, while glottic cancer patients (7/112, 6.3%) showed higher tendency to develop lung cancer than the hypopharyngeal cancer patients. Higher incidence was also observed for second primary cancers of mesopharyngeal, esophageal and gastric cancers in primary supraglottic cancer than in glottic cancer patients. Seventeen of 23(73.9%) patients with hypopharyngeal cancers had second primary esophageal cancers and 6 of 12 (50%) had second gastric cancers. Endoscopy with Lugol dye staining can detect clinically asymptomatic early esophageal and gastric cancers. CONCLUSION: Lugol dye endoscopy is indispensable and should be applied for routine screening of synchronous or metachronous carcinoma of aerodigestive tract once the hypopharyngeal and laryngeal cancers were diagnosed.