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目的 了解头颈部鳞癌的多原发癌发病部位和治疗、生存状况。方法 对 71例头颈部鳞状细胞癌 (简称鳞癌 )的多原发癌临床资料做了回顾性分析。结果 发生在头颈部的重复癌 2 7例 ,发生在非头颈部的重复癌 4 2例 ,另有三重癌 2例。本组共有同时性重复癌 4例 ,其中 1例是同时性三重癌。余 6 7例均为异时性重复癌 ,其中 1例为异时性三重癌。 6 7例异时性重复癌中 ,先证癌与重复癌发生的间隔期为 8个月～ 12年不等。 70 %的先证口腔鳞癌发生头颈部重复癌 ;6 2 %的先证下咽癌和 79%的先证喉癌发生非头颈部位的重复癌。非头颈部位以食管和肺部发生的重复癌较多。在所有头颈部鳞癌发生重复癌的部位中 ,以食管重复癌为最多 ,占本组病例的 2 4 %。本组病例总体3年、5年生存率分别为 32 4 %和 2 2 5 % ;重复癌治疗组和未治组的 3年生存率有明显统计学差异 ,治疗组明显高于未治组。结论 头颈鳞癌的重复癌以食管癌最为多见。口腔癌容易发生头颈部重复癌 ,喉癌和下咽癌易发生非头颈部重复癌。细致随访和复查、早期明确诊断和积极有效的治疗 ,可以提高这类患者的生存率。
Objective To investigate the incidence of multiple primary cancers and their treatment and survival in squamous cell carcinoma of the head and neck. Methods A retrospective analysis was made on the clinical data of 71 cases of multiple primary cancers of head and neck squamous cell carcinoma (SCC). The results occurred in the head and neck cancer recurrence in 27 cases, occurred in non-head and neck cancer recurrence 42 cases, and another triple carcinoma in 2 cases. In this group, there are 4 cases of simultaneous recurrent carcinoma, of which 1 case is concurrent triple carcinoma. The remaining 67 cases were allochronic recurrence cancer, including 1 case of heterotopic triple cancer. Sixty-seven cases of synchronous recurrence of cancer, Xian card cancer and recurrence of cancer interval of 8 months to 12 years. Seventy percent of first-degree oral squamous cell carcinoma of the head and neck recurrence of cancer; 6 2% of the first card hypopharyngeal carcinoma and 79% of the first laryngeal cancer non-head and neck cancer recurrence occurred. Non-head and neck parts of esophageal and pulmonary recurrence occurred more cancer. In all head and neck squamous cell carcinoma recurrence site, esophageal cancer was the most, accounting for 24% of the patients in this group. The overall 3-year, 5-year survival rates were 32 4% and 25 5% respectively. The 3-year survival rates of patients with and without cancer were significantly different, and the treatment group was significantly higher than the control group. Conclusion The recurrence of head and neck squamous cell carcinoma is the most common in esophageal cancer. Oral cancer is prone to repeated head and neck cancer, laryngeal cancer and hypopharyngeal cancer prone head and neck cancer recurrence. Careful follow-up and review, early diagnosis and effective diagnosis and treatment, can improve the survival rate of such patients.