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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 investigate the characteristics of onset, diagnosis and treatment of 53 patients with multiple primary malignancies and prognosis in order to raise awareness of multiple primary malignancies and guide the clinical diagnosis and treatment. Methods The clinical data of 53 patients with multiple primary malignancies admitted to Department of Oncology, Dongfang Hospital of Beijing University of Chinese Medicine from September 2013 to February 2016 were collected and analyzed retrospectively. Results 49 cases of primary malignant tumors, three primary malignant tumors in three cases, four primary malignant tumors in 1 case. A total of 111 malignant lesions were found, of which 33 were in the digestive system, 29 in the respiratory system, 20 in the head and neck, 11 in the mammary gland, 9 in the urinary system, 6 in the gynecological system and the other 3 in the gynecological system Brain, blood system. The survival time of 53 patients ranged from 2 to 360 months, and the median survival time was 60 months. The survival rates at 1, 3 and 5 years were 84.4%, 65.5% and 49.2%, respectively. Conclusion The high incidence of 60 to 79 years old, with double primary malignant tumor more common, predilection sites to the respiratory system, digestive system and head and neck more common. There are biased physique state to phlegm, blood stasis card mostly. The treatment method had an impact on the survival time. The first primary tumor chemotherapy was related to the overall survival (P <0.05), which was an independent prognostic risk factor.