Antal A, Vallent K
Semmelweis Orvostudományi Egyetem, Oktatókórház Sebészeti Osztály, Budapest.
Orv Hetil. 1997 Jun 8;138(23):1507-10.
Between 1989 and 1994, 719 patients had been treated with tumours at the Department of Surgery, Teaching Hospital of Semmelweis University Medical School, Budapest, Multiple tumours were found in 53 cases (7.37%), 49 of these being duplex and four triplex form. In men colorectal carcinoma was the most frequent while in women synchrone and metachrone breast cancers. Simultaneous breast tumors were most often found in senior patients (mean age 72.7) and metachrone ones at younger age (first tumor at 54.8 and the second one at 65.4 years of age, the following time being 10.6 years). Colorectal and gynecological tumours appeared with breast cancer in 5 cases. Regional colorectal tumours developed in five patients after radiotreatment of the pelvis. Familiar accumulation of colorectal cancer occurred in 4 cases. Lynch syndrome developed in 2 patients. The role of genetical factors is known in this group of illness, and they need to be screened. In this study the metachrone cancer in women occurred most frequently and only these patients received oncological treatment. The more effective treatment is supposed to enhance the number of multiplex tumours in which etiological factors also can play a role likewise mutagen effects of the first cancer therapies. The importance of collecting and processing these data is to referre to those risks, which should be considered in our everyday diagnostic work and postoperative care in these groups of patients.
1989年至1994年间,布达佩斯塞梅尔维斯大学医学院教学医院外科对719例肿瘤患者进行了治疗。53例(7.37%)发现有多发性肿瘤,其中49例为双发性,4例为三发性。男性中结直肠癌最为常见,女性中同步性和异时性乳腺癌最为常见。同时性乳腺肿瘤最常出现在老年患者中(平均年龄72.7岁),而异时性乳腺肿瘤则出现在较年轻患者中(第一个肿瘤发病年龄为54.8岁,第二个为65.4岁,间隔时间为10.6年)。5例患者的结直肠和妇科肿瘤与乳腺癌同时出现。5例患者在盆腔放疗后出现局部结直肠肿瘤。4例出现结直肠癌家族聚集现象。2例患者发生林奇综合征。遗传因素在这类疾病中的作用是已知的,需要对其进行筛查。在本研究中,女性异时性癌症最为常见,只有这些患者接受了肿瘤治疗。更有效的治疗可能会增加多发性肿瘤的数量,在这些肿瘤中病因学因素可能同样会像首次癌症治疗的诱变作用一样发挥作用。收集和处理这些数据的重要性在于提及那些在我们对这些患者群体的日常诊断工作和术后护理中应考虑的风险。