48 例胃肠道多原发性肿瘤的临床分析.pdfVIP

浙江临床医学 2005 年 1 月第 7 卷第 1 期 ·15 · 48 例胃肠道多原发性肿瘤的临床分析 张培趁 　程 　骏 　余作黔 　朱冠保 探讨胃肠道多原发肿瘤的临床特点 ,诊治原则和预后。 回顾性分析 1992～2003 年 48 例胃肠道多原发性肿瘤。 【摘要】　目的 　 方法 　 结果 　本组病例占同期胃肠道恶性肿瘤的 0. 83 % ,发病率低 , 同时癌27 例 ,异时癌 21 例 ,多原发大肠癌 32 例 , 胃多原发癌10 例 , 胃肠道多 原发癌 6 例 ,术前漏诊率为 30 % , 同时癌经手术治疗预后与单发癌相似,异时癌预后好于单发癌。结论 　胃肠道多原发肿瘤易漏诊,提高 疗效的关键在于早诊早治。 胃肠道肿瘤多　原发性　漏诊 【关键词】　 To investigate the clinical characteristics. treatment and diagnosis principle ,and the prognosis of multiple gastrointestinal can 【Abstract 】　Objective 　 cers. Methods 　A retrospective analysis was made on 48 cases of multiple gastrointestinal cancers fromJanuary 1992 toDecember 2003. Results 　The inci dence ofmultiple primary gastrointestinal carcinomas was 0. 83 % ,it ’s low. There were 27 synchronous carcinomas and 21 metachronous ones , 32 multiple col orectal cancer ,10 gastric multiple carcinomas ,6 gastrointestinal multiple carcinomas , misdiagnosis rate is 30 % ,Survival rate in patients with synchronous can cer were similar to that in patient with single tumor ,However patients with metachronous tumors had better prognosis than those with single cancer. Conclu sion 　Multiple primary gastrointestinal carcinomas was easily misdiagnosed. The key to improve the treatment is to be vigilant against lesions in the digestive tract so as to arrive at a timely diagnosis and treatment. 【Key word】　Gastrointestinal neoplasms 　Multiple primary cancers 　Misdiagnosed 　　胃肠道多原发肿瘤指在同一患者胃、肠道内发生不相 癌 3 例各有 3 处原发癌灶 ,异时癌 1 例有 3 处原发癌灶。累 关连的原发性恶性肿瘤 ;可同时发生也可异时发生。近年 及病灶数依次为直肠 , 升结肠 - 肝曲 , 胃窦,横结肠 , 以直 来 ,随着癌症诊断水平的提高 , 同一病人不同器官发生两种 肠 ,升结肠 - 肝曲 , 胃窦居多, 占52 % ,见表 1 。 或两种以上的原发肿瘤的发现率也越来越高。现将本院近