摘要
目的探讨恶性血液系统疾病合并肺癌患者的临床特点和预后。方法回顾性分析江苏省人民医院血液内科2009年1月至2018年12月期间经病理确诊为恶性血液系统疾病合并肺癌的26例患者的临床资料及预后情况。结果十年间共确诊恶性血液系统疾病7921例,其中合并肺癌者26例,在恶性血液系统疾病中,肺癌发生率为0.33%(26/7921),男女性别比为2.7:1;首次确诊恶性血液系统疾病至确诊肺癌的中位间隔时间为36个月(0~223个月),其中同时性多原发性恶性肿瘤(MPM)占26.9%(7/26),异时性MPM占73.1%(19/26):6~36个月占38.5%(10/26),36个月以上占34.6%(9/26);在异时性MPM中,肺癌在血液系统恶性疾病之前和之后确诊者分别占38.5%(10/26)和34.6%(9/26);第二原发恶性肿瘤发病年龄在70岁前后的中位生存时间分别为240个月和62个月(Log-rank=3.890,P=0.049<0.05);同时性MPM和异时性MPM的中位生存时间分别为13个月和103个月(Log-rank=24.696,P<0.01);两种恶性肿瘤间隔时间少于3年和超过3年的中位生存时间分别为19个月和103个月(Log-rank=12.396,P<0.01);除7例同时性肿瘤患者外,第一原发恶性肿瘤放化疗组和非放化疗组患者的中位生存时间分别为62个月和172个月(Log-rank=5.644,P=0.018<0.05)。结论恶性血液系统疾病合并肺癌患者中,第一原发恶性肿瘤的发病年龄和第二原发恶性肿瘤发病年龄越小预后越好,且两种恶性肿瘤发生的间隔时间越长预后越好;异时性MPM的第一原发肿瘤放化疗的患者预后差。
Objective To investigate the clinical characteristics and prognosis of malignant hematopoiesis combined with lung cancer.Methods The clinical data of 26 patients who admitted to Department of Hematology,Jiangsu Provincial Hospital and diagnosed with malignant hematopoiesis combined with lung cancer from January 2009 to December 2018,were retrospectively analyzed.Results From January 2009 to December 2018,7921 cases of malignant hematological diseases were diagnosed,including 26 cases with lung cancer(0.33%,26/7921).The male/female ratio was 2.7:1.The mean interval from the first diagnosis of the malignant hematological diseases to the diagnosis of lung cancer was 36 months(0-223 months):with 38.5%(10/26)of 6-36 months and 34.6%(9/26)of more than 36 months,and there were 7 cases(26.9%,7/26)of concurrent multiple primary malignancy(MPM)and 19 cases(73.1%,19/26)of heterogeneous MPM.Lung cancer was found and diagnosed before or after malignant hematopoiesis in 10(38.5%,10/26)and 9 cases(34.6%,9/26),respectively.The median survival time of the second primary malignant tumor at the age of less or more than 70 years old were 240 months and 62 months respectively(Log-rank=3.890,P=0.049<0.05).The median survival time of concurrent and asynchronous tumors was 13 months and 103 months,respectively(Log-rank=24.696,P<0.01).The median survival time of the two sites malignancies with an interval of less or more than 3 years were 19 months and 103 months,respectively(Log-rank=12.396,P<0.01).Excluding 7 patients with concurrent tumor,the median survival time was 62 months and 172 months,respectively,by radiochemotherapy or not(Log-rank=5.644,P=0.018<0.05).Conclusion In the malignant hematopoiesis patients complicated with lung cancer,the smaller the age of the first and second primary malignancies,the better the prognosis,and the longer the interval between the two malignancies,the better the prognosis.The prognosis of the first primary tumor of heterochronous MPM was poor after radiochemotherapy.
作者
张旭昌
江曼
王婷
王莉
李建勇
田发青
吴汉新
缪扣荣
ZHANG Xu-chang;JIANG Man;WANG Ting;WANG li;LI Jian-yong;TIAN Fa-qing;WU Han-xin;MIAO Kou-rong(Department of Hematology,Longgang District People's Hospital of Shenzhen,Shenzhen 518000,Guangdong,CHINA;Department of Oncology,the First Affiliated Hospital of Nanjing Medical University,Jiangsu Provincial Hospital,Nanjing 210009,Jiangsu,CHINA;Department of Hematology,the First Affiliated Hospital of Nanjing Medical University,Jiangsu Provincial Hospital,Nanjing 210009,Jiangsu,CHINA)
出处
《海南医学》
CAS
2019年第24期3140-3144,共5页
Hainan Medical Journal
基金
国家自然科学基金(81470329)
广东省深圳市龙岗区经济与科技发展专项资金医疗卫生科技计划项目(编号：LGKCYLWS2019000663)
关键词
多原发性恶性肿瘤
恶性血液系统疾病
肺癌
临床特征
预后
Multiple primary malignancy(MPM)
Malignant hematopoiesis
Lung cancer
Clinical characteristics
Prognosis
