中文摘要：

目的探讨合并肝细胞癌的多原发癌病人的临床特点。方法回顾性分析2012年1月至2016年6月浙江大学医学院附属第二医院肝胆胰外科连续收治的25例合并肝细胞癌的多原发癌病人临床资料。结果25例多原发癌病人占同期收治肝细胞癌病人（458例）的5.5%。其中，同时多原发癌8例（32.0%）；异时多原发癌17例（68.0%），其中首发为其他癌12例，首发为肝细胞癌5例。25例病人共发生肝外恶性肿瘤病灶26个，肺（26.9%）是肝外最常见的肿瘤累及器官，其次是胃（23.1%）。其中对肝细胞癌的治疗，1例（4.0%）行经导管肝动脉栓塞化疗治疗；2例（8.0%）行保守姑息治疗；22例（88.0%）行根治性手术，术后1、3年存活率分别为86.4%和72.7%。结论临床上合并肝细胞癌的多原发癌病人并不少见，肺癌和胃癌是常见的肝外恶性肿瘤，了解多原发癌的临床特点有助于减少误诊，从而使病人得到合理的治疗方案。

英文摘要：

Objective To explore the clinical characteristics of multiple primary malignances （MPM） in patients with hepatocellular carcinoma （HCC）. Methods The clinical data of 25 cases of MPM with HCC admitted between January 2012 and June 2016 in the Second Affiliated Hospital of Zhejiang University School of Medicine were analyzed retrospectively. Results Twenty-five cases of MPM accountted for 5.5% of HCC cases （458 cases） admitted in the same period. Among the 25 cases of MPM, 8（32%）cases were synchronous carcinoma and the other 17（68%） cases were metachronous carcinoma ,of which 12 initial malignances occurred in extrahepatic organs and 5 initial malignances presented HCC. A total of 26 extrahepatic malignant tumors were found in 25 cases. Lung cancer （26.9%） is the most common lesion in extrahepatic organ,followed by gastric cancer （23.1%）. As to the therapeutic method of HCC, 1 （4.0%） case received transcatheter arterial chemoembolization （TACE）,2 （8.0%） cases received palliative therapy, and the other 22 （88.0%） cases suffered radical operation. The 1- and 3-year survival rate were 86.4% and 72.7%, respectively. Conclusion MPM associated with HCC is not rare. Lung and stomach are common organs invaded by extrahepatic tumors. It’s necessary to have a better knowledge of MPM to reduce the misdiagnosis rate to make a reasonable therapeutic decision.