摘要
目的 研究黑斑息肉病病人肿瘤风险,明确其肿瘤易感性。方法 调查、总结治疗和收集的5 个黑斑息肉病家系32 例病人和7 例散发性病人,并结合国内近10 年的文献34 篇加以分析。结果 共169 例病人,恶性肿瘤发生率为20-1 % ,其中家族性病人90 例,恶性肿瘤发生率为20 % 。病理类型以低分化粘液腺癌为多。平均确诊年龄32-2 岁。消化道癌中,错构瘤癌变5 例,腺瘤癌变2 例。结论 黑斑息肉病病人是典型的恶性肿瘤高发人群。常见肿瘤依次为大肠癌、胃癌、小肠癌、宫颈癌和卵巢癌等。恶性肿瘤发病年龄轻,分化较差。在黑斑息肉病病人中存在错构瘤- 腺瘤- 癌的肿瘤发生途径,病人的一些( 发生LKB1 杂合性缺失的) 错构瘤和腺瘤性息肉应被视为癌前病变。
Objective To investigate the cancer risk in Peutz-Jeghers patients,and discuss the mechanism underlying its cancer predisposition.Methods To study the cancer incidence and characteristics in Chinese Peutz-Jeghers patients collected in our work and in Chinese literature in recent 10 years.Results The cancer incidence among these 169 patients is 20 1%,and 20% among larger Peutz-Jeghers pedigrees.The mean age of onset is 32 2 years,most cancers are of low differentiated mucous.5 gastrointestinal cancers developed from hamartomas,and 2 from adenoma polyps.Conclusion Peutz-Jeghers patients predispose to cancers of multiple organs.The most freqently seen cancers are colorectal,gastric,small intestineal,cervical and ovary cancers.These cancers have early onset and poor differentiation.A hamartoma-adenoma-cancer sequence exists in Peutz-Jeghers patients.Some hamartomas and adenomas(acquiring LKB1 LOH)should be treated as premalignant lesions.
出处
《中国实用外科杂志》
CSCD
北大核心
1999年第11期655-656,共2页
Chinese Journal of Practical Surgery
基金
国家青年863 基金