29例喉癌、下咽癌多原发癌临床分析

目的探讨喉癌、下咽癌多原发癌（multiple primary cancers,MPC）患者的临床特点。方法对29例喉癌、下咽癌MPC患者临床资料进行回顾性分析。结果本组病例中喉癌MPC以肺癌（20.7%,6/29）,下咽癌MPC以食道癌（24.1%,7/29）为最多见。本组MPC病理类型以鳞癌（占75.9%）最多见,有放、化疗史患者较易发生MPC（62.1%,18/29）,有烟、酒嗜好的患者较易发生MPC（58.6%,17/29）。本组总的3年、5年累积生存率分别为37.9%、24.1%。其中积极治疗组3年生存率达50.0%,放弃治疗组3年生存率为0,生存率差异有统计学意义（P=0.0253）。结论喉癌MPC以肺癌最多见,下咽癌MPC以食道癌最多见。有放、化疗史患者较易发生MPC。有烟酒嗜好的患者较易发生MPC。细致的随访和复查、早期明确诊断和积极有效地治疗可以提高MPC患者生存率。

Clinical Analysis of 29 Cases of Multiple Primary Cancers in Laryngeal or Hypopharyngeal Carcinoma

Objective To explore the clinical characteristics of the multiple primary cancers（MPC） in patients with laryngeal carcinoma（LC） or hypopharyngeal carcinoma（HC）. Methods Clinical data 29 patients with laryngeal or hypopharyngeal carcinoma in MPC were analyzed retrospectively. Results Lung carcinoma（20.7% ,6/29） was the most common MPC in 29 patients with LC, and esophageal carcinoma（24.1% ,7/29） is the most common MPC in 29 patients with HC. The squamous cell carcinoma（75.9% ） was the most common pathologic type among all MPC in 29 cases,which was more often seen among patients who had treated with radiotherapy or chemotherapy （ 62.1%, 18/29 ）, and patients who had smoked and drunk （ 58.6%, 17/29% ）. The total three-and five-year survival rates were 37.9% and 24.1% respectively of all MPC patients, the three-year survival rate for patients who received actively different therapies for their MPC was 50.0%, obviously higher than that of untreated patients whose three-year survival rate was 0. There was significant difference in the survival status between active therapies and untreated patients（P = 0.0235）. Conclusion Lung carcinoma was the most common MPC in LC and esophageal carcinoma in HC. MPC of the LC or HC were often seen among patients who had treated with radiotherapy or radiotherapy, and among patients who had smoked and drunk. Regular follow-up and early diagnosis with effective treatment can help to improve the survival rate of patients with MPC of the LC or HC.