Weaver A, Fleming S M, Knechtges T C, Smith D
Surgery. 1979 Sep;86(3):493-6.
Surgeons are sometimes embarrassed to discover a second unanticipated cancer while focusing attention on an already evident cancer in the head and neck area, the bronchus, or the esophagus. we began in October, 1976, to do direct laryngoscopy, esophagoscopy, and bronchoscopy on each of the 134 cases admitted to our unit with suspected head and neck cancer. In 10 of the 134 patients in whom triple endoscopy was done, no malignancy was found. Of 24 of 124 (20%) patients with head and neck cancer, 16 patients (13%) had synchronous carcinoma and eight patients (7%) had metachronous carcinoma in this 2-year period. The incidence can be expected to rise steadily with time and mandates "triple endoscopy" on all patients with a suspected cancer in the head and neck area, the bronchus, or the esophagus, as these structures form a closely related unstable field. The discovery of several patients with dysplastic mucosal changes, carcinoma in situ, or very early invasive cancer, not only of the head and neck but also of the esophagus and bronchus, presents new problems of management.
外科医生有时会尴尬地发现，在专注于头颈部、支气管或食管区域已明显存在的癌症时，还存在另一种意外的癌症。我们从1976年10月开始，对收治到我院的134例疑似头颈部癌症患者进行直接喉镜检查、食管镜检查和支气管镜检查。在接受三联内镜检查的134例患者中，有10例未发现恶性肿瘤。在124例（20%）头颈部癌症患者中，有24例，在这两年期间，16例患者（13%）患有同步癌，8例患者（7%）患有异时癌。随着时间的推移，这一发病率预计会稳步上升，因此对于所有疑似头颈部、支气管或食管癌症的患者都必须进行“三联内镜检查”，因为这些结构形成了一个密切相关的不稳定区域。发现了几例不仅在头颈部，而且在食管和支气管出现发育异常黏膜改变、原位癌或极早期浸润癌的患者，这带来了新的管理问题。
