摘要
目的探讨53例多原发恶性肿瘤患者的发病特点、诊疗方式及预后转归,以期提高对多原发恶性肿瘤的认识,指导临床诊疗工作。方法收集北京中医药大学东方医院肿瘤科自2013年9月至2016年2月收治的53例多原发恶性肿瘤患者的病历,对其临床资料进行回顾性分析。结果双原发恶性肿瘤49例,三原发恶性肿瘤3例,四原发恶性肿瘤1例。共发现111个恶性肿瘤病灶,其中33个位于消化系统,29个位于呼吸系统,20个位于头颈部,11个位于乳腺,9个位于泌尿系统,6个位于妇科系统,其他3个发生于脑、血液系统。53例患者生存时间范围为2-360个月,中位生存时间为60个月,1,3,5年生存率分别为84.4%,65.5%,49.2%。结论高发年龄为60-79岁,以双原发恶性肿瘤多见,好发部位以呼吸系统、消化系统及头颈部多见。均存在体质偏颇状态,以痰湿、血瘀证居多。治疗方式对其生存期有影响,第一原发肿瘤化疗与总生存期有关（P〈0.05）,为独立的预后危险因素。
Objective To study the characteristic, diagnosis and treatment method, prognosis and outcome of multiple primary malignant neoplasms （MPMNs） in 53 cases, thus to understand MPMNs better and to guide clinic. Methods 53 patients with MPMNs from September, 2013 to February, 2016 were involved in this study. All the data in Dongfang Hospital, Beijing University of Chinese Medicine were collected to conduct retrospective analysis. Results There were 49 cases with duplex primary malignant neoplasms（DPMNs）, 3 cases with triple primary malignant neoplasms, 1 case with quadruple primary malignant neoplasms. There were 111 malignant neoplasms lesions in 53 MPMNs patients, including 33 located in alimentary system, 29 in respiratory system, 20 in head and neck, 11 in mammary gland, 9 in urinary system, 6 in gynecology system and 3 in brain, hematological system. The survival time of the 53 patients ranged from 2 to 360 months. With a median survival time of 60 months, 1 year, 3 year and 5 year cumulative survival rate in 53 patients were 84.4%, 65.5% and 49.2%. Conclusion Among MPMNs, the high-incidence age ranged from 60 -79 and DPMNs occurred more often. The common locations of MPMNs were alimentary system, respiratory system, and head and neck. 53 MPMNs patients had unbalanced physique, and both phlegm-damp and blood stasis occurred most. Treatment methods had an effect on survival time. Chemotherapy during first primary malignant neoplasmsis was a independent risk factor to the survival time in MPMNs, which showed statistical difference （P 〈 0.05 ）.
出处
《现代中医临床》
2016年第4期28-32,共5页
Modern Chinese Clinical Medicine
基金
北京中医药大学东方医院人才培养计划(No.DFRC2014A06)
北京中医药大学中西医结合肿瘤治疗协同创新中心(No.2013-XTCX-05)
关键词
肿瘤
多原发恶性肿瘤
同时性
异时性
neoplasms
multiple primary malignant neoplasms
synchronous
metachronous
