X-ray diagnosis of synchronous multiple primary carcinoma in the upper gastrointestinal tract

Table 1 Age and sex distribution of the 59 patients with multiple primary carcinoma included in this study

		Gender		Age(yr)
	n	Male	Female	Range	Mean	≥ 55
Esophageal MPC	24	13	11	44-85	61.63	15/24 (62.5%)
Esophageal and gastric MPC	27	24	3	42-72	59.89	20/27 (74.07%)
Gastric MPC	8	7	1	48-76	64.38	7/8(87.5%)

MPC: Multiple primary carcinoma.

Table 2 Distance between every two esophageal lesions

Esophageal MPC	n (%)	Interval distance (cm)
		Range	Mean
Upper-middle	12 (50.00)	5-12.5	8.36
Upper-lower	5 (20.83)	8-13	11.20
Middle-lower	7 (29.17)	5-9	5.83

MPC: Multiple primary carcinoma.

Table 3 Clinicopathological differences of esophageal lesions between esophageal multiple primary carcinoma and esophageal-gastric multiple primary carcinoma

	EMPC			EGMPC
	Total (n = 49)	First lesion	Second or third lesion	(n = 27)
Location
Upper	17	17	0	0
Middle	19	7	12	16
Lower	13	0	13	11
Largest dimension of lesions (cm)
mean ± SD1	4.33 ± 2.35	3.63 ± 1.96	5.00 ± 2.67	5.56 ± 2.34
95% CI	3.63-5.02	2.80-4.45	3.90-6.10	4.63-6.48
Morphology
Hyperplastic	23	11	12	11
Medullary	9	4	5	7
Ulcerative	7	5	2	5
Infiltrative	7	3	4	2
Mixed	3	0	3	2
Histology
Squamous cell carcinoma	49	24	25	26
Sarcoma	0	0	0	1
PT stage2
T1	12	9	3	13
T2-4	37	15	22	14

¹Largest dimension of esophageal lesions (cm) between first lesion and second lesion, t = 2.047, P = 0.046. Largest dimension of esophageal lesions (cm) between esophageal multiple primary carcinoma (EMPC) and esophageal-gastric multiple primary carcinoma (EGMPC), t = 2.139, P = 0.036;

²PT stage of esophageal lesions between first lesion and second lesion, χ² = 4.306 P = 0.038; PT stage of esophageal lesions between EMPC and EGMPC, χ² = 4.414, P = 0.036.

Table 4 Clinicopathological differences of gastric lesions between gastric multiple primary carcinoma and esophageal-gastric multiple primary carcinoma

	GMPC			EGMPC
	Total (n =16)	Main lesion	Additional lesion	(n = 27)
Location
Cardia	8	1	7	16
Fundus	0	0	0	1
Body	3	3	0	3
Antrum	5	4	1	7
Largest dimension of lesions (cm)
Mean ± SD1	2.94 ± 1.39	3.93 ± 1.21	1.94 ± 0.62	4.94 ± 2.63
95% CI	2.20-3.68	2.93-4.95	1.42-2.46	3.90-5.98
Morphology
Hyperplastic	13	5	8	17
Ulcerative	1	1	0	6
Infiltrative	2	2	0	4
Histology
Squamous cell carcinoma	0	0	0	4
Adenocarcinoma	16	8	8	23
PT stage2
T1	6	1	5	3
T2~4	10	7	3	24

¹Largest dimension of gastric lesions (cm) between main lesion and additional lesion, t = 4.161, P = 0.001. Largest dimension of gastric lesions (cm) between gastric multiple primary carcinoma (GMPC) and esophageal-gastric multiple primary carcinoma (EGMPC), t = 2.820, P = 0.007.

²PT stage of gastric lesions between main lesion and additional lesion, χ² = 4.267, P = 0.039, PT stage of gastric lesions between GMPC and EGMPC, χ² = 4.227, P = 0.040.

Table 5 Clinicopathological characteristics of 19 misdiagnosed synchronous multiple primary carcinomas

Type	Age	Gender	Largest dimension (cm)		Location of lesion		PT stage
			Diagnosed	Missed	Diagnosed	Missed
1 EMPC	49	Female	3.3	2.2	Middle	Lower	T4/T1
2 EMPC	58	Male	3.4	1	Lower	Upper	T2/T1
3 EMPC	67	Male	4.7	2.5	Middle	Lower	T3/T1
4 EMPC	73	Female	5.5	1.8	Middle	Upper	T3/T1
5 EMPC	64	Male	6.2	2	Lower	Upper	T2/T1
6 EMPC	57	Male	4.5	1,5	Lower	Middle	T2/T1
7 EGMPC	65	Female	6.5	2.2	Lower	Body	T4/T2
8 EGMPC	54	Male	5.5	2.5	Lower	Fundus	T3/T1
9 EGMPC	58	Male	4.5	1.8	Cardia	Middle	T3/T1
10 EGMPC	62	Male	3.2	2.8	Cardia	Middle	T3/T1
11 EGMPC	72	Male	3.5	5.7	Cardia	Lower	T4/T3
12 EGMPC	63	Male	4.2	3.2	Lower	Antrum	T2/T1
13 EGMPC	70	Male	2.8	2.5	Cardia	Middle	T2/T1
14 EGMPC	60	Male	4.2	2	Antrum	Middle	T3/T1
15 EGMPC	60	Male	4.2	2.2	Cardia	Middle	T3/T1
16 EGMPC	57	Male	4.5	3.5	Lower	Cardia	T3/T3
17 GMPC	52	Male	2.2	2.8	Cardia	Antrum	T2/T1
18 GMPC	57	Male	4.5	1.2	Antrum	Cardia	T3/T1
19 GMPC	64	Male	5.5	2.2	Antrum	Cardia	T3/T1

GMPC: Gastric multiple primary carcinoma; EGMPC: Esophageal-gastric multiple primary carcinoma; EMPC: Esophageal multiple primary carcinoma.