第二原发癌为肺癌的多原发癌患者临床分析

目的:收集第二原发癌为肺癌的多原发癌(lung cancer as second primary malignancy,LCSPM)患者临床特点、肿瘤部位和生存预后等临床信息进行回顾性分析,以期为指导临床实践提供一定的研究证据.方法:回顾性收集上海交通大学附属胸科医院2012年1月至2016年2月LCSPM患者病例,采用卡方检验和Fisher精确概率法比较分类资料,Kaplan-Meier法进行生存分析,得到影响LCSPM患者生存的因素及生存率.结果:LCSPM患者第一原发癌最多见的是乳腺癌,其次是上呼吸消化道恶性肿瘤、甲状腺癌和结直肠癌;两原发癌的中位间隔时间是72个月,53.9％的患者超过5年;LCSPM患者2年生存率为71.2％,手术和分期可影响预后.结论:对于存在肿瘤史的病人,随访同一器官的同时其他器官的情况也不容忽视.及早发现、及早治疗并争取手术机会,LCSPM患者的生存期将显著延长.

Clinical analysis of the patients with lung cancer as a second primary malignancy

Objective:To retrospectively analyze the clinical characters,tumor location and prognosis of the patients with lung cancer as second primary malignancy (LCSPM),and to provide some research evidence to guide clinical practice.Methods:We collected cases of LCSPM in Shanghai Chest Hospital,Shanghai Jiao Tong University,from January 2012 to February 2016.The chi-square test was used for categorical variables,and survival curves were calculated by the Kaplan-Meier method,and then we obtained the influence factors for survival and the survival rate of LCSPM patients.Results:Breast,upper aerodigestive,thyroid and colorectum were the most prevalent initial primary tumors;the median interval between the two tumors was 72 months;surgery and stage of lung cancer were factors that affect the survival of LCSPM patients.Conclusion:Other organs should not be ignored in the follow-up of patients with a history of cancer.Early detection for surgical opportunity of lung cancer can extend the survival of the LCSPM patients.