多原发性肺癌1例报告并文献复习

A Case Report of Multiple Primary Lung Cancer and Literature Review

摘要: 多原发性肺癌(MPLC)是临床罕见的肺癌类型，指单肺或双肺不同部位发生两个及以上独立起源的原发肺癌，按发病时间分为同步性和异时性，其诊断标准历经多次优化但尚未形成统一共识，且不同病理类型共存的MPLC临床报道尤为稀缺。本文报道1例62岁男性同步性多原发性肺癌患者，该患者同时确诊右肺腺癌、左肺上叶鳞状上皮原位癌、左肺下叶小细胞癌三种病理类型，为临床罕见病例。结合该病例的临床资料、诊疗过程，并查阅国内外相关文献，对MPLC的发病率、诊断方法、发病机制、预后影响因素及治疗策略进行叙述性文献回顾，旨在提高临床医师对MPLC的认知水平，为这类罕见病例的早期诊断、个体化治疗提供参考依据，减少临床漏诊、误诊情况的发生。

Abstract: Multiple primary lung cancer (MPLC) is a rare clinical type of lung cancer, referring to two or more primary lung cancers with independent origins occurring in different parts of a single lung or both lungs. It is divided into synchronous and metachronous types according to the onset time. Its diagnostic criteria have been optimized for many times but no unified consensus has been formed, and clinical reports of MPLC with coexisting different pathological types are particularly scarce. This paper reports a 62-year-old male patient with synchronous multiple primary lung cancer, who was diagnosed with three pathological types including right lung adenocarcinoma, squamous cell carcinoma in situ of the left upper lung and small cell carcinoma of the left lower lung at the same time, which is a rare clinical case. Combined with the clinical data and diagnosis and treatment process of this case, and by reviewing the relevant domestic and foreign literature, this paper systematically summarizes the incidence, diagnostic methods, pathogenesis, prognostic factors and treatment strategies of MPLC, aiming to improve clinicians’ cognitive level of MPLC, provide reference for early diagnosis and individualized treatment of such rare cases, and reduce the occurrence of clinical missed diagnosis and misdiagnosis.