Plot Leeor, Dovrish Zamir, Hadari Ruth, Weisenberg Noemi, Zehavi Tania, Nisenbaum Bella, Amital Howard
Department of Internal Medicine D, Meir Medical Center, Kfar Saba.
Harefuah. 2008 Apr;147(4):294-8, 376, 375.
Cancer of unknown primary site (CUP) is defined as a metastatic disease, identified on biopsy, with it's origin remaining unknown despite extensive clinical, laboratory and imaging studies. As much as 3% to 10% of all cancers can be defined as CUP. The primary workup includes history taking, a full physical examination, basic laboratory studies, imaging studies and immunohistochemical staining or genetic analysis of biopsy material. The diagnostic yield of such studies is about 20% to 30% of cases. New advanced techniques can be used to define the genetic profile of the tumor cells. Comparing such profiles to those originating from known tumors may markedly improve our ability to detect the origin of CUP in up to 90% of cases. The treatment of CUP is based on the regimen given for cancer of the presumed origin, and in many cases is completely empiric. The prognosis for patients with CUP is dismal partially due to the late stages in which the disease is diagnosed and the aggressiveness of the tumor. The median survival is 10-12 months and the 2 year survival is 20%-25%. This is a case report demonstrating the dilemmas in managing such patients, followed by a review of the recent medical literature covering the topic.
原发部位不明的癌症（CUP）被定义为一种经活检确诊的转移性疾病，尽管进行了广泛的临床、实验室和影像学检查，但其起源仍不清楚。所有癌症中多达3%至10%可被定义为CUP。初步检查包括病史采集、全面体格检查、基础实验室检查、影像学检查以及对活检材料进行免疫组化染色或基因分析。这些检查的诊断率约为病例的20%至30%。可使用新的先进技术来确定肿瘤细胞的基因图谱。将这些图谱与已知肿瘤的图谱进行比较，可能会显著提高我们在高达90%的病例中检测CUP起源的能力。CUP的治疗基于针对推测起源癌症的治疗方案，在许多情况下完全是经验性的。CUP患者的预后很差，部分原因是疾病诊断时已处于晚期且肿瘤具有侵袭性。中位生存期为10 - 12个月，2年生存率为20% - 25%。这是一份病例报告，展示了管理此类患者时的困境，随后是对涵盖该主题的近期医学文献的综述。
