论文部分内容阅读
目的探讨合并肝细胞癌的多原发癌病人的临床特点。方法回顾性分析2012年1月至2016年6月浙江大学医学院附属第二医院肝胆胰外科连续收治的25例合并肝细胞癌的多原发癌病人临床资料。结果 25例多原发癌病人占同期收治肝细胞癌病人(458例)的5.5%。其中,同时多原发癌8例(32.0%);异时多原发癌17例(68.0%),其中首发为其他癌12例,首发为肝细胞癌5例。25例病人共发生肝外恶性肿瘤病灶26个,肺(26.9%)是肝外最常见的肿瘤累及器官,其次是胃(23.1%)。其中对肝细胞癌的治疗,1例(4.0%)行经导管肝动脉栓塞化疗治疗;2例(8.0%)行保守姑息治疗;22例(88.0%)行根治性手术,术后1、3年存活率分别为86.4%和72.7%。结论临床上合并肝细胞癌的多原发癌病人并不少见,肺癌和胃癌是常见的肝外恶性肿瘤,了解多原发癌的临床特点有助于减少误诊,从而使病人得到合理的治疗方案。
Objective To investigate the clinical features of multiple primary cancer patients with hepatocellular carcinoma. Methods The clinical data of 25 patients with multiple primary hepatocellular carcinoma who were consecutively treated in hepatobiliary and pancreatic surgery at the Second Affiliated Hospital of Medical College of Zhejiang University from January 2012 to June 2016 were retrospectively analyzed. Results 25 cases of multiple primary cancer accounted for 5.5% of patients (458 cases) with hepatocellular carcinoma in the same period. Among them, there were 8 cases (32.0%) with multiple primary cancers and 17 cases (68.0%) with multiple primary cancers at the same time, of which 12 cases were other cancers and 5 cases were hepatocellular carcinoma. Thirty-six patients had extrahepatic malignancies (26.9%), the most common organ involvement in the extrahepatic tissues, followed by the stomach (23.1%). Among them, the treatment of hepatocellular carcinoma was treated with transcatheter arterial chemoembolization in 1 case (4.0%), conservative palliative treatment in 2 cases (8.0%), radical surgery in 22 cases (88.0%), and postoperative one to three years Survival rates were 86.4% and 72.7%, respectively. Conclusions It is not uncommon for multiple primary cancers with clinically complicated hepatocellular carcinoma. Lung cancer and gastric cancer are common extrahepatic malignant tumors. Understanding the clinical features of multiple primary cancers may help to reduce misdiagnosis so that patients may receive reasonable treatment plans .