【作者】 林小提；

【导师】 张祥福；

【作者基本信息】 福建医科大学 ， 肿瘤学， 2006， 硕士

【摘要】 目的探讨本地区多原发性癌的临床特点及预后。方法回顾性分析我科1972年6月至2006年1月内收治,经手术病理确诊为多原发性癌患者116例;应用SPSS12.0软件进行生存分析,对再发癌为胃癌的多原发性癌各临床指标与预后的关系进行Cox单因素和多因素分析。结果116例多原发性癌占同期收治的全部恶性肿瘤的1.56%,其中男性70例,女性46例,首发癌发病年龄为23~82岁,平均年龄54.23岁,再发癌发病年龄为28~93岁,平均年龄57.86岁。同时性多原发性癌60例,异时性多原发性癌56例。间隔时间于3年内占71.67%。发生器官最多见于同一器官及同一系统。治疗原则以手术为主的综合治疗。本组116例MPC1,3及5年生存率分别为70.49%、39.11%及25.15%;50例再发癌为胃癌的多原发性癌的1,3及5年生存率分别为82.58%、48.74%及25.99%,与原发性胃癌的5年生存率无显著性差异(P>0.05);对再发癌为胃癌的多原发性癌各项临床指标,行Kaplan-Meier及log-rank单因素分析显示间隔时间、肿瘤家族史、根治性手术及病理分期都与生存密切相关。而年龄、性别、首发癌部位及病理类型与生存期无关。Cox模型进行多因素分析发现仅间隔时间及病理分期与生存期有关。结论在积极治疗下,多原发性癌仍有相当高的生存率;多原发性癌中再发胃癌,在积极治疗下,其5年生存率与原发性胃癌相等,异时性再发胃癌生存率高于同时性再发胃癌,早期诊断、早期治疗是提高再发胃癌生存率的关键之一。更多还原

【Abstract】 Objective To study some clinical traits and prognostic factors of the local Multiple Primary Cancers(MPC). Methods From June 1972 to January 2006,116 cases with MPC were included.The relationship between clinical data and prognosis of MPC with the second primary gastric carcinoma(SPGC) were analyzed by SPSS12.0. Results The MPC accounted for 1.56% of all patients with malignant tumors in the same period. Out of them 70 patients were male,46 patients were female.The age of first primary carcinoma ranged from 23 to 82 old-year,the average 54.23 old-year. The age of second primary carcinoma ranged from 28 to 93 old-year,the average 57.86 old-year.While 60 cases were synchronous MPC,56 cases were metachronous MPC. The interval times within 3 years accounted for 71.67% of all interval times.The most possible organs of the MPC occurred in the same organ or the same system. The principle of treatment of the MPC was surgery.The overall 1-,3-, 5-year survival rates of MPC were 70.49%、39.11% and 25.15%, respectively. The overall 1-,3-, 5-year survival rates of SPGC were 82.58%、48.74% and 25.99%, respectively. Kaplan-Meier and Log-rank univariate analysis showed that interval time,familial record,complete resection and pathological staging were closely associated with survival rates (P<0.05);while age,gender,organ of first carcinoma and pathological type were not associated with survival rates. Cox model multivariate analysis indicated that interval time and pathological staging were closely associated with更多还原