CAJ | 학술논문

目的探讨妇科恶性肿瘤相关的多发性原发性恶性肿瘤(MPMN)的临床特点.方法采用回顾性分析方法,对2007年1月至2012年12月南京医科大学第一附属医院收治的30例妇科恶性肿瘤相关MPMN患者的临床病理资料进行分析.结果 30例患者中,同时性MPMN 9例,平均年龄为50.2岁,中位年龄为49岁,发生部位包括卵巢、子宫、子宫颈、乳腺、肠道;异时性MPMN患者21例,平均年龄为57.7岁,中位年龄为57岁,中位发病间隔时间为4.0年,发生部位在乳腺、卵巢、子宫、胃肠道、子宫颈、肺等.30例患者中,26例采用手术治疗并根据分期及病理结果辅以化疗和(或)放疗.余4例患者,3例行第1原发性恶性肿瘤切除术后辅以化疗和(或)放疗,第2肿瘤未切除而行化疗和(或)放疗;1例均未行手术治疗,仅行化疗和(或)放疗.随访29例,随访时间为6 ～ 60个月,仍存活20例.妇科恶性肿瘤相关MPMN患者的5年累积生存率为47.8％,2年生存率为73.9％,1年生存率为88.6％.结论重视妇科恶性肿瘤相关MPMN,对有高危因素的恶性肿瘤患者进行全面检查,鉴别复发、转移还是新的原发性恶性肿瘤,做到早发现、早诊断、早治疗,避免误诊、漏诊.
목적 탐토부과악성종류상관적다발성원발성악성종류(MPMN)적림상특점.방법 채용회고성분석방법,대2007년1월지2012년12월남경의과대학제일부속의원수치적30례부과악성종류상관MPMN환자적림상병리자료진행분석.결과 30례환자중,동시성MPMN 9례,평균년령위50.2세,중위년령위49세,발생부위포괄란소、자궁、자궁경、유선、장도;이시성MPMN환자21례,평균년령위57.7세,중위년령위57세,중위발병간격시간위4.0년,발생부위재유선、란소、자궁、위장도、자궁경、폐등.30례환자중,26례채용수술치료병근거분기급병리결과보이화료화(혹)방료.여4례환자,3례행제1원발성악성종류절제술후보이화료화(혹)방료,제2종류미절제이행화료화(혹)방료;1례균미행수술치료,부행화료화(혹)방료.수방29례,수방시간위6 ～ 60개월,잉존활20례.부과악성종류상관MPMN환자적5년루적생존솔위47.8％,2년생존솔위73.9％,1년생존솔위88.6％.결론 중시부과악성종류상관MPMN,대유고위인소적악성종류환자진행전면검사,감별복발、전이환시신적원발성악성종류,주도조발현、조진단、조치료,피면오진、루진.
Objective To investigate the clinical features of gynecological malignant tumor related multiple primary malignant neoplasms (MPMN).Methods Apply retrospective and comprehensive analysis to the clinical data of 30 patients with gynecological malignant tumor related MPMN.Results Synchronous MPMN were found in 9 patients.Their average age was 50.2 years old and their median age was 49 years old.The neoplasms were located at ovary,uterus,cervix,breast and intestine.Metachronous MPMN were found in 21 patients.Their average age was 57.7 and their median age was 57 years old.The median interval between the first and the second primary malignant neoplasm was 4.0 years.The neoplasms were located at breast,ovary,uterus,gastrointestinal tract,uterine cervix,lung etc.In 30 cases,26 of them were treated by surgical operation and further adjunctive treatment of chemotherapy and (or) radiotherapy was conducted as per the neoplasm staging and its pathological results.The rest 4 patients (first primary malignant neoplasms were excised from 3 of them and another one was not treated by surgical operation) received adjunctive treatment of chemotherapy and (or) radiotherapy.Followed ups,which varied from 6 to 60 months,were made to 29 patients and 20 out of the 29 were alive.5-year survival rate of patients with gynecological malignant tumor related MPMN was 47.8％,2-year survival rate was 73.9％,and 1-year survival rate was 88.6％.Conclusion Pay more attention to the patients with gynecological malignant tumor related MPMN,examine the high-risk patients with malignant tumor comprehensively,identify whether it is recurrence,metastasis or new growth of malignant neoplasm,and further ensure early diagnosis and proper treatment,avoiding misdiagnosis and missed diagnosis.