Diagnosis,Surgical Treatment And Prognosis Of Synchronous Multiple Primary Lung Adenocarcinoma

Objective:Multiple primary lung adenocarcinoma as the main types of multiple primary lung cancer,its incidence in recent years is rising.This study through retrospectively study the patients lived in Chinese academy of medical sciences cancer hospital from January 1,2013 to December 31,2014,to explore the diagnosis and treatment of this kind of disease.Methods:Collecting the clinical data and follow-up the lifetime of 65 SMPLA patients.The clinical data include preoperative examination,surgical procedure and postoperative pathological results.Collecting the data and inductive corresponding survival analysis.The associated prognosis factors respectively tested by Kaplan Meier-single factor analysis,single factor significance test by the Log Rank(Mantel-Cox)method,P<0.05 defined as statistical significance.Results:This group of cases,92.3%(60/65 cases)were found by HRCT.CEAhas the highest positive rate of tumor markers,with positive rate of 29.2%.The joint use of multiple tumor markers can increase positive rate to 44.2%.When the lesions located in different lungs,lobectomy with partial lobectomy is the most common resection surgery.Gland bubble type growth mode is the commonest of all lesions,in total of 78,53.8%of all lesions.The second is attached to the wall type growth mode,in total of 28 cases,accounting for 19.3%.The overall survival rate of three years is 88.9%.After Kaplan Meier-single factor analysis,the factors associated with survival are the largest diameter of the largest lesions,lymph node metastasis or not,differentiation degree and finally TNM staging of patients.Conclusion:HRCT is the best way to diagnosis SMPLA before surgery.The joint use of multiple tumor markers can increase positive rate.Lobectomy with sub-lobectomy is the commonest resection surgery.SMPLA with surgical treatment can obtain similar prognosis of single primary lung adenocarcinoma.Similar to single primary lung adenocarcinoma,the largest diameter of the largest lesions,lymph node metastasis or not,differentiation degree and finally TNM staging of patients are associated with overall survival rate.So early found and early treatment is very important to improve the prognosis.The adjuvant to stage ? SMPLA patients deserves further discussion.