Objective To investigate the effect of tumor suppressor gene on tumourigenesis in multiple primary malignant neoplasm (MPMN).Methods The retrospective analysis was used to summarize several common tumor suppressor genes correlation to MPMN. Results At current study of the tumor suppressor genes, the common genes studied in MPMN were p53, APC, p16, BRCA1, BRCA2 and PTEN/MMAC1, etc. The same mutation of tumor suppressor genes could be detected from PMNNs. Conclusion There are significant relations between MPMN and inactivation of tumor suppressor gene. By the study of tumor suppressor gene, it can reveal some common rules of tumourigenesis of MPMN.
Thirty one cases of multiple primary colorectal carcinoma (MPCC) have been treated in our hospital since 1980, which account for 2.1%(31/1 450) of the patients with colorectal carcinoma in the corresponding period .Twentytwo of them were synchronous carcinoma and 9 cases metachronous carcinoma. Among the 31 cases there were 26 cases with two primary carcinomas, two cases with three primary carcinomas, 1 case with four primary carcinomas and two cases with five primary carcinomas. After reviewing the literature concerned , the author made an analysis of the incidence, the factors inducing MPCC takes place and the diagnosis and the treatment of the disease with emphasis on the discussion of the misdiagnosis and preventive measures.
A microsatellite is a short, repetitive sequence of DNA (usually 2 to 4 nucleotides in length). Multiple primary lung cancers (MPLC) are more than one primary lung cancer lesions arising synchronously in different locations of the same or different side of the lung. These neoplasms may have same or different histological types, but one lesion is not a metastasis from another, as each neoplasm arises independently in the lung. Abnormal microsatellite changes are closely related to the pathogenesis and development of MPLC. In this review, several aspects are discussed:①definition and origin of microsatellite; ②abnormal changes of microsatellite; ③definition and categories of MPLC; ④the influence of microsatellite on early diagnosis, treatment and prognosis of MPLC.
Objective To evaluate the efficacy and safety of computed tomography (CT)-guided percutaneous and cone beam CT-guided transbronchial ablation in the treatment of early multiple primary lung cancer (MPLC). Methods Retrospective analysis was performed on patients who met inclusion criteria in Shanghai Chest Hospital between May 2020 to June 2022. According to ablation pathway, lesions were divided into two groups: percutaneous ablation group and transbronchial ablation group. Results A total of 13 MPLC patients with 26 lesions were included (14 percutaneous ablation and 12 transbronchial ablation). There were no statistically significant differences in solid component, lesion location, lung field and lesion size between the two groups. The distance from the parietal pleura in the transbronchial ablation group was longer than that in percutaneous ablation group (P=0.03). The median follow-up period time were 13 months and 12 months for group percutaneous ablation and transbronchial ablation. No significant differences were found in 3-month complete ablation rate (100.0% vs. 83.3%), 1-year local control rate (100.0% vs. 91.7%) and severe complication rate (7.1% vs. 16.7%). The minor complication rate in percutaneous ablation group was higher than that in transbronchial ablation group (50.0% vs 0.0%, P=0.02). Conclusions Percutaneous ablation and transbronchial ablation have high efficacy and safety, and the latter involves lower minor complication rate. They complement each other, which provide the individualized treatments for early MPLC patients who are not suitable for or refuse surgery.
ObjectiveTo evaluate the safety and efficacy of simultaneous surgical resection combined with thermal ablation in sequential treatment of patients with multiple primary lung cancer (MPLC). MethodsPatients with MPLC who underwent simultaneous, sequential surgical resection combined with thermal ablation at Shangjin Branch of West China Hospital of Sichuan University from April 2023 to May 2024 were retrospectively included, and their perioperative and follow-up data were analyzed. ResultsA total of 23 MPLC patients with an average age of (51.61±12.38) years, 4 males and 19 females were included. Cumulatively, 48 lesions were resected and 23 lesions were ablated. About half of the patients (52.17%) had surgery and ablation treatment located in the same lung. All patients completed the combined treatment without intraoperative complications. Four patients had postoperative complications, and were effectively managed and successfully discharged. The median postoperative hospital stay was 4.00 (4.00, 4.00) days. The average follow-up duration was (11.78±4.90) months, with a local control rate of 100.00% at 6 months postoperatively. No deaths or tumor occurred during the follow-up. Conclusion Simultaneous surgery with thermal ablation in sequential treatment for MPLC is safe, flexible and effective, providing a new option for this group of patients, but further studies are needed to evaluate its long-term efficacy.
With the popularization of CT technology, more and more multiple primary lung cancer, that is, the simultaneous presence of more than one primary cancer in the lungs, has been detected. Imaging can make a rough judgment, histopathology is still the diagnostic gold standard, and molecular genetics examination can better distinguish it from intrapulmonary metastatic cancer when necessary. At present, there is no unified treatment standard for multiple primary lung cancer. Surgery is the most important and effective means, and the surgical method needs to be personalized according to the size and distribution of the patient's lesions, one-sided lobectomy and the other side sublobar resection is considered safe and feasible. At the same time, local nonsurgical treatment is also an option or a supplement to surgical treatment. This article reviews the diagnosis and treatment of multiple primary lung cancer in recent years.
Objective To investigate the pathological features， diagnosis， treatment， and prognosis of multiple primary colorectal cancer （MPCC）. Methods Clinical data of 41 patients with MPCC treated in The Fourth Affiliated Hospital and The First Affiliated Hospital of China Medical University from Aug. 1993 to Mar. 2009 were retrospectively analyzed. Results Forty one patients with MPCC， including 29 patients with synchronous colorectal cancer （SCC） and 12 patients with metachronous colorectal cancer （MCC）， accounted for 1.8% （41/2 340） of colorectal cancer during the same period of time， and with adenomatous polyps in 19 cases and polyps canceration in 10 cases. Among 29 patients with SCC， 15 cases （51.7%） were diagnosed by preoperative fiberoptic colonoscopy， 9 cases （31.0%） were diagnosed by preoperative fiberoptic colonoscopy， abdomen CT， and barium enema， 5 cases （17.2%） were diagnosed by intraoperative exploration and intraoperative fiberoptic colonoscopy， respectively. All of the 12 patients with MCC were diagnosed by preoperative fiberoptic colonoscopy and abdomen CT. For 29 patients with SCC， tumor locations were from proximal appendix to distal rectum， but 12 patients with MCC were adverse. Sixty-five （77.4%） tumors were tubular or papillary adenocarcinoma， and 56 （66.7%） tumors were well and moderately differentiated adenocarcinoma. The TNM stage of most tumors （72） was stageⅡ or Ⅲ phase， account for 85.7%. Radical surgeries were performed in 37 patients and palliative surgeries in 4 patients， and there were no complications after operation. During the follow-up for 3-5 years （mear 3.6 years）， the overall survival rate of 3- and 5-year were 48.8% （20/41） and 34.1% （14/41）， respectively. In detail， 3-year survival rate of SCC group and MCC group were 48.3% （14/29） and 50.0% （6/12）， respectively；5-year survival rate were 31.0% （9/29） and 41.7% （5/12）， respectively. Conclusions Cause of MPCC has not been clear， but it has possible relationship with adenomatous polyps. Preoperative fiberoptic colonoscopy， abdomen CT， and barium enema are very important for patients with SCC， and intraoperative fiberoptic colonoscopy is also necessary. Patients with MCC should enhance postoperative follow-up with fiberoptic colonoscopy. Further more， radical resection should be performed as early as possible.
Objective To study the diagnosis and surgical treatment of multi-primary esophageal carcinoma. Methods The data of 29 patients of multi-primary esophageal carcinoma were collected .The diagnosis was made by dye-staining through gastroscopy and X-ray examination.Pathological examination after operation was analyzed.Three kinds of operations were used: 22 by radical resection, 5 by partial resection and 2 by surgical exploration. Results Twenty-one patients were diagnosed before operation,8 patients were diagnosed during and after operation. Sixty-seven foci and 6 early stage patients were found. The complications were found in 7 patients.No patient died during operation. Twenty-five patients were followed up. The follow up time was 7-36 months.1-year survival rate 77.8%,3-year survival rate 41.6%. Conclusion Routine X-ray examination of esophagus, and esophageal dye-staining and/or biopsy through endoscopy are important measures for early diagnosis of multi-primary esophageal carcinoma.Prompt surgery is advised.
【Abstract】Objective To analyze the clinical features of multiple primary colorectal carcinoma(MPCC). Methods Data in 21 patients with MPCC during the past 10 years in our hospital were analyzed retrospectively. Results The incidence of synchronous and metachronous carcinoma was 1.1% and 1.2% respectively. The sites and pathologic stages of tumors showed no significant difference compared with single colorectal carcinoma. 47.6% of the cases accompanied with colorectal adenoma. 77.8% of the MPCC could be found during operation. Patients with carcinoma involved rectum had relatively poor survival. Conclusion The full-course colonoscopy, careful intraoperative exploration and regular postoperative colonoscopic follow-up are essential in improving the diagnosis and prognosis of patients with MPCC.
With the changes in the disease spectrum and the advancement of examination technology, the detection rate of multiple primary lung cancers (MPLC) is gradually increasing when multiple nodules and masses in the lung are examined clinically. MPLC has significant distinction with other types of lung diseases or lung cancers in the treatment and prognosis. In most cases, patients would be recommended to undergo the surgery as soon as possible which means that the accurate diagnosis should be made before surgery or during treatment. The newly developed molecular and genomic methods are more likely to better determine the relationship between multiple lesions. Artificial intelligence can be used as a related diagnostic aid to show more accurate and objective results in the diagnosis of multiple pulmonary nodules. This review summarizes the latest MPLC diagnostic research (including pathological analysis, imaging), analyzes surgical treatment methods, and looks forward to the future research direction of MPLC diagnosis and treatment, in order to provide reference for MPLC research.