[Analysis on the Prognostic and Survival Factors of Synchronous Multiple Primary Lung Cancer].

• DOI: 10.3779/j.issn.1009-3419.2017.01.03
• Publication Date: 2017-01-20
• Authors: Haifa Guo; Feng Mao; Hui Zhang; Yangbo Qiu; Yang Shen-Tu
• Keywords: Primary tumor

Synchronous multiple primary lung cancer (sMPLC) is a sparse disease in the past, but there has been gradual increase morbidity of sMPLC recently. However, studies on large sample have never undertaken. The purpose this study to investigate diagnosis, treatment and prognosis through analyzing clinical data, provide supports for management sMPLC.According Martini-Melamed criteria, 357 patients were diagnosed sMPLC. pathological staging basis 8th edition tumor-node-metastasis (TNM) from International Association Study Lung Cancer (IASLC).There 269 with double cancer, 65 triple 23 four or more cancer. Lesions (68.55%, 571/833) frequently upper lobe, especially right lobe. Adenocarcinoma (95.56%, 796/833) was mainly type, followed by squamous cell carcinoma (2.40%, 20/833). acinar predominant subtype main part (70.81%, 313/442) all adenocarcinoma specimens. Most lesions (68.35%, 244/357) stage Ib low. Among initial lesion following ,patients who had same type (92.72%, 331/357) than different (7.28%, 26/357), which adenocarcinoma-adenocarcinoma occupied major proportion (99.40%, 329/331). 3-year overall survival (OS) 5-year respective 91.93% 84.37%. Multivariate analysis found that smoking history (P=0.012), diameter maximum (P=0.027), lymph node metastasis (P=0.015) pleural invasion (P<0.001) independent risk factors prognosis.Tumours are type. Smoking history, lesion, prognosis. Early diagnosis active operation can obtain better prognosis.背景与目的 同时性多原发肺癌（synchronous sMPLC）既往属少见疾病，近年发病率呈持续上升趋势，但缺乏对其大样本的研究报道。本研究对357例sMPLC的临床病理资料进行分析总结，籍以为临床诊断、治疗及预后提供理论依据。方法 参考Martini-Melamed诊断标准和国际肺癌研究协会（International Cancer, IASLC）第8版肿瘤-淋巴结-转移（tumor-node-metastasis, TNM）分期标准，对357例sMPLC的临床病理资料进行分析。结果 357例患者中，双原发病灶269例（75.35%），三原发病灶65例（18.21%），四原发病灶及以上者23例（6.44%），最多者为8个病灶。病灶好发于上叶，特别是右上叶（35.77%, 298/833），病理类型以腺癌为主（95.56%, 796/833），鳞癌次之（2.40%, 20/833），腺癌亚型中以腺泡样为主的比例较高（70.81%, 313/442），分期以Ib期及以下为主（68.35%, 244/357）。病理类型相同者发病率（92.72%, 331/357）远高于不同病理类型（7.28%, 26/357），其中腺癌-腺癌比例较高（99.40%, 329/331）。sMPLC的3年总生存率（overall survival, OS）为91.93%，5年总生存率为84.37%，多因素生存分析显示，有吸烟史（P=0.012）、最大病灶直径大于2 cm（P=0.027）、淋巴结转移（P=0.015）和胸膜受累（P<0.001）为影响sMPLC预后生存的独立危险因素。结论 sMPLC好发于右上叶，以腺癌最常见，腺泡样为主的亚型多见。吸烟史、最大结节直径、淋巴结转移和胸膜侵犯是影响sMPLC预后生存的独立危险因素。早期发现和积极的手术可以使sMPLC患者获得较好的预后。.