[1]赵 岩,李 勇,胡宝山,等.回顾性总结56例肝细胞癌合并肝外原发恶性肿瘤[J].介入放射学杂志,2015,(01):34-37.
 ZHAO Yan,LI Yong,HU Bao shan,et al.Primary hepatocellular carcinoma associated with extra hepatic malignancies: retrospective analysis of 56 cases[J].journal interventional radiology,2015,(01):34-37.
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回顾性总结56例肝细胞癌合并肝外原发恶性肿瘤 ()

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《介入放射学杂志》[ISSN:1008-794X/CN:31-1796/R]

卷:
期数:
2015年01期
页码:
34-37
栏目:
肿瘤介入
出版日期:
2015-01-25

文章信息/Info

Title:
Primary hepatocellular carcinoma associated with extra hepatic malignancies: retrospective analysis of 56 cases
作者:
赵 岩 李 勇 胡宝山 何 旭 黄建文 占美晓 陆骊工
Author(s):
ZHAO Yan LI Yong HU Bao shan HE Xu HUANG Jian wen ZHAN Mei xiao LU Li gong.
Department of Interventional Radiology, Guangdong Provincial People’s Hospital, Guangdong Academy of Medical Sciences, Guangzhou, Guangdong Province 510080, China
关键词:
【关键词】 肝细胞癌 多原发肿瘤 临床特征 预后
文献标志码:
A
摘要:
【摘要】 目的 分析肝细胞癌合并肝外原发恶性肿瘤患者的临床特征。方法 回顾性分析56例原发性肝细胞癌合并肝外原发恶性肿瘤患者临床特征,包括肝外原发恶性肿瘤分布部位、治疗方式、与肝细胞癌发生的时间关系;对肝细胞癌患者确诊时的临床特征进行描述,对影响多原发恶性肿瘤患者总生存期及肝细胞癌患者特异生存期的临床特征进行单因素、多因素分析。结果 肝外原发恶性肿瘤多发部位依次为胃、结肠直肠、鼻咽部和肺部;24例为同时诊断恶性肿瘤,32例为先后诊断恶性肿瘤;67.9%患者会在出现第1个原发肿瘤后3年内再发生第2个原发肿瘤。同时癌与异时癌比较,两组在年龄、性别、肝炎、血清甲胎蛋白、肝功能Child Pugh分级、巴塞罗那分期、肝细胞癌治疗方式、肝外原发肿瘤治疗方式、肝硬化、肿瘤数目、肿瘤最大直径、门静脉侵犯、肿瘤家族史、吸烟史等各组间差异均无统计学差异(P > 0.05)。多因素分析显示,肝外原发肿瘤治疗方式及同时癌、异时癌分组会影响多原发恶性肿瘤患者的总生存期。生存分析显示:肝外原发恶性肿瘤获得根治性治疗以及异时癌组患者可获得较好的总生存期;肝细胞癌治疗方式、肝功能Child Pugh分级是影响肝细胞癌特异生存期的临床因素;患者接受根治性手术切除、肝功能Child Pugh A级患者可获得较长的肝细胞癌特异生存期。结论 肿瘤患者治疗后应进行定期复查,特别是最初3年对胃、结肠直肠、鼻咽部和肺部等高发部位的筛查;对肝内、肝外肿瘤积极治疗可以获得较好的生存期。

参考文献/References:

[1] Mariotto AB, Rowland JH, Ries LA, et al. Multiple cancer prevalence: a growing challenge in long term survivorship[J]. Cancer Epidemiol Biomarkers Prev, 2007, 16: 566 571.
[2] 中华人民共和国卫生部. 原发性肝癌诊疗规范(2011年版)[J]. 临床肿瘤学杂志, 2011, 16: 929 946.
[3] Fernández Ruiz M, Guerra Vales JM, Castelbón Fernández FJ, et al. Multiple primary malignancies in Spanish patients with hepatocellular carcinoma: analysis of a hospital based tumor registry[J]. J Gastroenterol Hepatol, 2009, 24: 1424 1430.
[4] Demandante CG, Troyer DA, Miles TP. Multiple primary malignant neoplasms: case report and a comprehensive review of the literature[J]. Am J Clin Oncol, 2003, 26: 79 83.
[5] Sankila R, Pukkala E, Teppo L. Risk of subsequent malignant neoplasms among 470 000 cancer patients in Finland, 1953 - 1991[J]. Int J Cancer, 1995, 60: 464 470.
[6] 徐玲玲, 顾康生. 170例多原发恶性肿瘤的临床分析[J]. 安徽医科大学学报, 2011, 46: 1318 1321.
[7] 贾卫华, 许宗利, 冯炳健, 等. 广东鼻咽癌高危家族成员发病危险性的流行病学研究[J]. 癌症, 2004, 23: 767 770.
[8] 董雪娟, 蔡昌豪, 吴本俨, 等. 119例老年消化系统多原发恶性肿瘤的临床分析[J]. 解放军医学杂志, 2008, 33: 317 319.
[9] Forner A, Llovet JM, Bruix J. Hepatocellular carcinoma[J]. Lancet, 2012, 379: 1245 1255.
[10]董家鸿, 郑树森, 陈孝平, 等. 肝切除术前肝脏储备功能评估的专家共识(2011版)[J]. 中华消化外科杂志, 2011, 10: 20 25.

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备注/Memo

备注/Memo:
(收稿日期:2014-03-03)
(本文编辑:俞瑞纲)
更新日期/Last Update: 2015-01-26