Associations between small intestine cancer and other primary cancers:: An international population-based study
Associations between small intestine cancer and other primary cancers:: An international population-based study
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DOI：
10.1002/ijc.21284
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发表时间：
2006-01-01
影响因子：
6.4
通讯作者：
Brennan, P
中科院分区：
文献类型：
--
作者：
Scélo, G;Boffetta, P;Brennan, P
小肠癌是一种罕见的肿瘤，其病因仍知之甚少。对小肠癌患者的其他原发肿瘤的分析可能有助于阐明这种肿瘤的原因和潜在的机制。在一项汇集分析中，我们纳入了来自13个癌症登记处的10,946例首次原发性小肠癌病例。观察到的44种第二原发癌的数量与根据每个登记中特定年龄、性别和日历时期的癌症发病率得出的预期数量进行了比较。我们还计算了小肠癌的标准化发病率(SIR)，作为仅次于其他癌症的第二原发癌。小肠癌后发生新的原发癌症的风险总体上增加了68%(SIR=1.68，95%可信区间[CI]=1.47-1.71)，随着时间的推移保持不变。肿瘤、肉瘤和淋巴瘤的SIR分别为1.18(95%CI=1.05~1.32)、1.29(1.01~1.63)和1.27(0.78~1.94)。口咽癌、结肠癌、直肠癌、瓦特壶腹癌、胰腺癌、子宫体癌、卵巢癌、前列腺癌、肾癌、甲状腺癌、皮肤癌和软组织癌的发病率显著增加(P<；0.05)。除口咽癌和肾癌外，作为第二原发癌的小肠癌在所有这些癌症之后显著增加。尽管其中一些过度可能是由于过度诊断，但似乎大多数额外的第二原发癌病例都与临床相关，并由常见的遗传因素(例如错配或其他DNA修复途径的缺陷)和环境因素(例如饮食因素)引起。(C)2005年Wiley-Liss，Inc.
Cancer of the small intestine is a rare neoplasm, and its etiology remains poorly understood. Analysis of other primary cancers in individuals with small intestine cancer may help elucidate the causes of this neoplasm and the underlying mechanisms. We included 10,946 cases of first primary small intestine cancer from 13 cancer registries in a pooled analysis. The observed numbers of 44 types of second primary cancer were compared to the expected numbers derived from the age-, gender- and calendar period-specific cancer incidence rates in each registry. We also calculated the standardized incidence ratios (SIR) for small intestine cancer as a second primary after other cancers. There was a 68% overall increase in the risk of a new primary cancer after small intestine carcinoma (SIR = 1.68, 95% confidence interval [CI] = 1.47-1.71), that remained constant over time. The overall SIR was 1.18 (95% CI = 1.05-1.32) after carcinoid, 1.29 (1.01-1.63) after sarcoma, and 1.27 (0.78-1.94) after lymphoma. Significant (p < 0.05) increases were observed for cancers of the oropharynx, colon, rectum, ampulla of Vater, pancreas, corpus uteri, ovary, prostate, kidney, thyroid gland, skin and soft (issue sarcomas. Small intestine cancer as a second primary was increased significantly after all these cancers, except after oropharyngeal and kidney cancers. Although some of the excess may be attributable to overdiagnosis, it is plausible that most additional cases of second primary cancers were clinically relevant and were due to common genetic (e.g., defects in mismatch or other DNA repair pathways) and environmental (e.g., dietary) factors. (c) 2005 Wiley-Liss, Inc.