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[80岁以上患者肺与消化道同步双癌的两例手术病例及基因诊断]

[Two operated cases of synchronous double cancer of the lung and digestive tract in patients over 80 years old and genetical diagnosis].

作者信息

Nosaka S, Nakayama K, Nio Y, Yamauchi M, Gu K, Sasaki T, Saito Y, Sato Y, Tamura K

机构信息

First Department of Surgery, Shimane Medical University, Izumo, Japan.

出版信息

Kyobu Geka. 1996 Feb;49(2):111-5.

PMID:8691677
Abstract

Synchronous double cancer of the lung and gastrointestinal organ was successfully resected by an one-step approach in two aged patients over 80 years. An 81-year-old man was clinically diagnosed as having a right lung cancer (S3) along with a sigmoid colon cancer. The pathological cell types of these cancers were squamous cell carcinoma and adenocarcinoma respectively. Right upper lobectomy and sigmoidectomy were performed at the same time because he had no risks for the operation. An-80-year-old woman was diagnosed as having a left lung cancer (S8-9) along with a stomach cancer. The cell types of these cancers were both highly differentiated adenocarcinoma. Left lower lobectomy and subtotal gastrectomy were performed at the same time, too. We limited lymph nodes dissection to shorten the operation time and no postoperative complications occurred in both patients. It is suggested that simultaneous operation for double cancer in aged patients can be safely performed in selected cases. In the latter patient, pathological cell type of the lung cancer was similar to that of stomach cancer. So we applied polymerase chain reaction (PCR) for making a diagnosis of double cancer postoperatively, and it was proved that the lung and gastric cancers were different from each other in genetical natures. Application of the genetical technique to clinical field which greatly contribute to making a diagnosis of double cancer is expected.

摘要

两名80岁以上的老年患者通过一步法成功切除了同步发生的肺癌和胃肠道器官癌。一名81岁男性临床诊断为右肺癌(S3)合并乙状结肠癌。这些癌症的病理细胞类型分别为鳞状细胞癌和腺癌。由于他没有手术风险,因此同时进行了右上叶切除术和乙状结肠切除术。一名80岁女性被诊断为左肺癌(S8-9)合并胃癌。这些癌症的细胞类型均为高分化腺癌。同时也进行了左下叶切除术和胃次全切除术。我们限制了淋巴结清扫以缩短手术时间,两名患者均未发生术后并发症。提示在老年患者中,对于部分病例可以安全地进行双癌同期手术。在后一名患者中,肺癌的病理细胞类型与胃癌相似。因此我们应用聚合酶链反应(PCR)对术后双癌进行诊断,结果证明肺癌和胃癌在基因性质上彼此不同。期望将基因技术应用于临床领域,这将极大地有助于双癌的诊断。

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