消化系统多原发癌临床分析

目的：探讨消化系统多原发癌的临床特点，诊治原则及预后。方法：回顾性分析本院1992年1月--2001年12月10年间经术后病理证实的消化系统多原发癌。结果：经计算机病案管理系统检索出39例消化系统多原发癌，其中双原发癌37例，三原发癌2例；同时癌20例，异时癌19例；累及病灶数以结肠、胃居多，占48．8％；消化系统多原发癌的术前漏诊30％；异时癌3年以内发生为68．4％；5年生存率33．3％，均为异时性结肠多原发癌。结论：消化系统多原发癌多发于结肠，异时癌的第二癌多发生于第一癌治疗后的1．3年内；消化系统多原发癌术前漏诊率高，应行综合性诊断方法；异时性结肠多原发癌患的预后较好。

The clinical analysis of multiple primary cancers in the digestive system

Objective To investigate the clinical characteristics, treatment and diagnosis principle, and the prognosis of multiple primary cancers in the digestive system. Methods A retrospective analysis was made on 39 cases of multiple primary cancers in the digestive system which were confirmed by pathological check from january 1992 to december 2001. Result 39 cases of multiple primary cancers were observed, There were 20 synchronous carcinomas and 19 metachronous ones which mainly involved colon and stomach. Five year survival rate was 33.3%. Conclusion High frequence of multiple primary cancers was found in the colon, The second cancer of metachronous cancers usually occure in 1 to 3 year after the treatment of the first cancer. The rate of missed diagnosis of multiple primary cancers is high and comprehensiveness diadynamic method should be done. The prognosis of metachronous colon multiple primary cancers is relatively good.