Ławniczak Małgorzata, Gawin Alicja, Jaroszewicz-Heigelmann Halina, Rogoza-Mateja Wiesława, Raszeja-Wyszomirska Joanna, Białek Andrzej, Karpińska-Kaczmarczyk Katarzyna, Starzyńska Teresa
Małgorzata Ławniczak, Alicja Gawin, Halina Jaroszewicz-Heigelmann, Wiesława Rogoza-Mateja, Andrzej Białek, Teresa Starzyńska, Department of Gastroenterology, Pomeranian Medical University, 71-252 Szczecin, Poland.
World J Gastroenterol. 2014 Jun 21;20(23):7480-7. doi: 10.3748/wjg.v20.i23.7480.
To determine the prevalence and characteristics of additional primary malignancies in gastric cancer (GC) patients.
GC patients (862 total; 570 men, 292 women; mean age 59.8 ± 12.8 years) diagnosed at the Department of Gastroenterology at Pomeranian Medical University over a period of 23 years were included in this retrospective analysis of a prospectively maintained database. Mean follow-up time was 31.3 ± 38.6 mo (range 1-241 mo). The following clinicopathological features of patients with synchronous tumors were compared to those with metachronous tumors: age, sex, symptom duration, family history of cancer, tumor site, stage (early vs advanced), histology, and blood group. GC patients with and without a second tumor were compared in terms of the same clinicopathological features.
Of 862 GC patients, 58 (6.7%) developed a total of 62 multiple primary tumors, of which 39 (63%) were metachronous and 23 (37%) synchronous. Four (6.9%) of the 58 multiple GC patients developed two or more neoplasms. The predominant tumor type of the secondary neoplasms was colorectal (n = 17), followed by lung (n = 9), breast (n = 8), and prostate (n = 7). Age was the only clinicopathological feature that differed between GC patients with synchronous vs metachronous malignancies; GC patients with synchronous neoplasms were older than those with metachronous neoplasms (68.0 ± 10.3 years vs 59.9 ± 11.1 years, respectively, P = 0.008). Comparisons between patients with and without a second primary cancer revealed that the only statistically significant differences were in age and blood group. The mean age of the patients with multiple GC was higher than that of those without a second primary tumor (63.4 ± 11.4 years vs 59.5 ± 13.0 years, respectively, P = 0.026). GC patients with a second primary tumor were more commonly blood group O than those without (56.2% vs 31.6%, respectively, P = 0.002).
GC patients may develop other primary cancers; appropriate preoperative and postoperative diagnostic modalities are thus required, particularly if patients are older and blood group O.
确定胃癌（GC）患者中额外原发性恶性肿瘤的患病率及特征。
回顾性分析在23年期间于波美拉尼亚医科大学胃肠病科确诊的GC患者（共862例；男性570例，女性292例；平均年龄59.8±12.8岁），这些数据来自一个前瞻性维护的数据库。平均随访时间为31.3±38.6个月（范围1 - 241个月）。将同时性肿瘤患者与异时性肿瘤患者的以下临床病理特征进行比较：年龄、性别、症状持续时间、癌症家族史、肿瘤部位、分期（早期与晚期）、组织学类型及血型。对有和无第二肿瘤的GC患者的相同临床病理特征进行比较。
862例GC患者中，58例（6.7%）共发生62个多原发性肿瘤，其中39例（63%）为异时性肿瘤，23例（37%）为同时性肿瘤。58例多原发性GC患者中有4例（6.9%）发生了两种或更多种肿瘤。继发性肿瘤的主要类型为结直肠癌（n = 17），其次为肺癌（n = 9）、乳腺癌（n = 8）和前列腺癌（n = 7）。年龄是同时性与异时性恶性肿瘤的GC患者之间唯一不同的临床病理特征；同时性肿瘤的GC患者比异时性肿瘤的患者年龄更大（分别为68.0±10.3岁和59.9±11.1岁，P = 0.008）。有和无第二原发性癌症患者之间的比较显示，唯一具有统计学显著差异的是年龄和血型。多原发性GC患者的平均年龄高于无第二原发性肿瘤的患者（分别为63.4±11.4岁和59.5±13.0岁，P = 0.026）。有第二原发性肿瘤的GC患者血型为O型的比无第二原发性肿瘤的患者更常见（分别为56.2%和31.6%，P = 0.002）。
GC患者可能发生其他原发性癌症；因此需要适当的术前和术后诊断方式，特别是对于年龄较大且血型为O型的患者。
