胃食管早期多原发肿瘤12例分析

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英文篇名：Clinical features of 12 multifocal gastroesophageal neoplasms 作者：王沧海 ; 吴静 ; 刘红 ; 刘揆亮 ; 宿慧 ; 魏南 英文作者：Wang Canghai;Wu Jing;Liu Hong;Liu Kuiliang;Su Hui;Wei Nan;Department of Gastroenterology,Beijing Shijitan Hospital,Capital Medical University;Faculty of Gastroenterology of Capital Medical University; 关键词：胃食管肿瘤 ; 多原发 ; 临床特点 英文关键词：gastroesophageal neoplasms;;multifocal;;clinical features 中文刊名：SDYD 英文刊名：Journal of Capital Medical University 机构：首都医科大学附属北京世纪坛医院消化内科首都医科大学消化病学系; 出版日期：2018-10-17 17:48 出版单位：首都医科大学学报 年：2018 期：v.39 基金：首都卫生发展科研专项项目(2016-1-2022)~~ 语种：中文; 页：SDYD201805012 页数：5 CN：05 ISSN：11-3662/R 分类号：63-67

摘要

目的探讨胃食管多原发肿瘤的临床特点、治疗及预后。方法分析首都科医科大学附属北京世纪坛医院近十年来胃镜检查发现的胃食管多原发肿瘤患者,分析其临床及内镜下特征和手术方式。结果本院10年来胃镜下诊断胃肿瘤患者358例,食管癌患者201例,其中单发胃食管早癌患者68例,胃食管多原发肿瘤病例共12人,其中同时多原发肿瘤9例,异时多原发肿瘤3例。术前漏诊2例,均为Ⅱb型病变。结论多原发胃食管肿瘤,尤其是副病灶多为早期肿瘤,内镜容易漏诊,应加强应用放大内镜、内镜窄带成像术(narrow band imaging,NBI)及化学染色方法,避免漏诊,提高患者生存率。
        Objective To study the clinical features of the patients with multifocal gastroesophageal neoplasms.Methods Analysis the patients with multifocal gastroesophageal neoplasms who were treated in our hospital from 2008 to 2018.Results Twelve patients were diagnosed with multifocal gastroesophageal neoplasms,with nine synchronous carcinoma and three metachronous carcinoma.Two patients with synchronous caricinoma were missed with endoscopy.Conclusion The accessory lesion of gastroesophageal was always early gastric cancer,which was prone to missed diagnosis.It's important to use narrow band imaging(NBI),magnify and chemical dying to avoid missed diagnosis.

引文

[1]吴道宏,吴洲红,吴本俨,等.多原发早期胃癌临床病理特征及预后分析[J].中国肿瘤临床与康复,2009,16(1):19-21.
    [2] Nagasawa S,Onda M,Sasajima K,et al. Multiple primary malignant neoplasms in patients with esophageal cancer[J].Dis Esophagus,2000,13(3):226-230.
    [3] Utada M,Ohno Y,Hori M,et al. Incidence of multiple primary cancers and interval between first and second primary cancers[J]. Cancer Sci,2014,105(7):890-896.
    [4] Ribeiro U Jr,Jorge U M,Safatle-Ribeiro A V,et al. Clinicopathologic and immunohistochemistry characterization of synchronous multiple primary gastric adenocarcinoma[J]. J Gastrointest Surg,2007,11(3):233-239.
    [5]孙洁,李学良.食管早癌及癌前病变伴食管外原发肿瘤的临床分析[J].胃肠病学和肝病学杂志,2017,26(8):894-897.
    [6] Urabe Y,Hiyama T,Tanaka S,et al. Metachronous multiple esophageal squamous cell carcinomas and Lugol-voiding lesions after endoscopic mucosal resection[J]. Endoscopy,2009,41(4):304-309.
    [7]李麦冬,胡长路.多原发癌176例临床分析[J].安徽医药,2017,21(12):2222-2224.
    [8]张培趁,程骏,余作黔,等. 48例胃肠道多原发性肿瘤的临床分析[J].浙江临床医学,2005,7(1):15-16.
    [9] Kato M,Nishida T,Yamamoto K,et al. Scheduled endoscopic surveillance controls secondary cancer after curative endoscopic resection for early gastric cancer:a multicentre retrospective cohort study by Osaka University ESD study group[J]. Gut,2013,62(10):1425-1432.
    [10]朱一苗,潘文胜.异时性多原发上消化道肿瘤[J].实用肿瘤杂志,2014,29(5):457-460.
    [11]李小毅,钟定荣,陈思,等.胃癌合并其他器官原发癌103例分析[J].中国普外基础与临床杂志,2012,19(1)43-47.
    [12]李伟,李建生,张海南,等. MR扩散加权成像对提高直肠癌内镜活检阳性率价值分析[J].中华肿瘤防治杂志,2015,22(5):382-386.
    [13] Schroeder C C,侯庆生,郭洪亮.微小直肠类癌内镜治疗研究现状[J].中华肿瘤防治杂志,2016,23(10):694-698.
    [14]赵丽,张晓梅,孙刚,等.色素内镜—食管多原发癌早期诊断的有效手段[J].胃肠病学和肝病学杂志,2017,26(5):534-535.
    [15]曹长琦,李士杰,李子禹,等.窄带成像技术在诊断上消化道多原发癌中的应用价值[J].肿瘤防治研究,2012,39(8):997-1000.