高龄老年多原发恶性肿瘤65例临床分析

目的探讨高龄老年多原发恶性肿瘤（multiple primary neoplasms,MPN）临床特点,提高对老年MPN的认识。方法回顾性分析65例高龄MPN患者的临床资料。结果调查老年恶性肿瘤患者472例,其中MPN65例,占13.8%。确诊第一肿瘤时中位年龄76岁。发病最常见的系统为呼吸、消化及泌尿生殖系统,最常见的器官为肺、胃及前列腺。组织病理学最常见的实体瘤依次是腺癌、移行细胞癌及鳞癌。中位生存时间69月。同时性MPN及异时性MPN在生存时间上差异无显著性（P=0.42）。二原发异时性MPN两肿瘤中位间隔时间88月,≥5年组及〈5年组生存时间差异无显著性（P=0.87）。结论老年人MPN发病率明显升高,但恶性程度相对较低,生存时间长,应得到足够的重视。

Clinical Analysis of 65 cases with Multiple Primary Neoplasms in Advanced Age

Objective To investigate the clinical characters of multiple primary neoplasms(MPN) in advanced age,and to improve understanding of MPN in the elderly.Methods Clinical data of 65 patients with MPN in advanced age were retrospectively analyzed.Results 472 elderly patients had malignant tumors,and among them 65 had MPN,accounting for 13.8%.The median age was 76 years old when the first tumors were diagnosed.The most common involved systems were respiratory,digestive,and urogenital system.The most common organs were lung,stomach and prostate.The most common solid tumors of histological results were adenocarcinoma,transitional cell carcinoma and squamous cell carcinoma.The median survival time was 69 months.There was no statistical significant for survival time between synchronous and metachronous multiple primary neoplasms.Duplex metachronous primary neoplasms had a median interval time of 88 months between the two neoplasms,and there was no statistical significant for survival time between the group which the interval time was over and even 5 years and the group less 5 years.Conclusion The incidence of MPN in the elderly was significantly increased,but the degree of malignancy is relatively lower,and patients mostly have long survival time.Therefore,MPN in the elderly should be given adequate attention and further investigation.