Increased risk of additional cancers among patients with gastrointestinal stromal tumors: A population-based study.
Increased risk of additional cancers among patients with gastrointestinal stromal tumors: A population-based study.
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DOI：
10.1002/cncr.29434
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发表时间：
2015-09-01
期刊：
影响因子：
6.2
通讯作者：
Sicklick JK
中科院分区：
文献类型：
--
作者：
Murphy JD;Ma GL;Baumgartner JM;Madlensky L;Burgoyne AM;Tang CM;Martinez ME;Sicklick JK
大多数胃肠道间质瘤（GIST）被认为是非遗传性或散发性的。然而，单机构研究表明，GIST患者发生其他恶性肿瘤的频率增加。我们假设，我们可以通过国家癌症数据库查询更深入地了解GIST和其他恶性肿瘤之间可能的关联。纳入监测、流行病学和最终结果数据库中诊断为GIST的患者（2001-2011年）。标准化患病率（SPRs）和标准化发病率（SIRs）分别用于量化GIST患者在GIST诊断前后发生的癌症风险，并与美国普通人群进行比较。在6,112名GIST患者中，1,047名（17.1%）患有其他癌症。总体癌症发生率显著增加：诊断前为44%（SPR=1.44），诊断后为66%（SIR=1.66）。诊断前后发生率显著增加的恶性肿瘤包括其他肉瘤（SPR=5.24/SIR=4.02）、神经内分泌类癌（SPR=3.56/SIR=4.79）、非霍奇金淋巴瘤（SPR=1.69/SIR=1.76）和结直肠腺癌（SPR=1.51/SIR=2.16）。食管腺癌（SPR=12.0）、膀胱腺癌（SPR=7.51）、黑色素瘤（SPR=1.46）和前列腺腺癌（SPR=1.20）仅在GIST前显著更常见。卵巢癌（SIR=8.72），小肠腺癌（SIR=5.89），甲状腺乳头状癌（SIR=5.16），肾细胞癌（SIR=4.46），肝胆腺癌（SIR=3.10），胃腺癌（SIR=2.70），胰腺癌（SIR=2.03），子宫腺癌仅在GIST后，非小细胞肺癌（SIR =1.96）、非小细胞肺癌（SIR=1.74）和膀胱移行细胞癌（SIR=1.65）显著更常见。这是第一个以人群为基础的研究，以描述GIST和其他癌症之间的关联和时间关系，无论是部位还是组织学类型。这些关联可能对未来的癌症筛查和治疗策略具有重要的临床意义。
Most gastrointestinal stromal tumors (GIST) are considered non-hereditary or sporadic. However, single-institution studies suggest that GIST patients develop additional malignancies with increased frequencies. We hypothesized that we could gain greater insight into possible associations between GIST and other malignancies using a national cancer database inquiry. Patients diagnosed with GIST (2001–2011) in the Surveillance, Epidemiology, and End Results database were included. Standardized prevalence ratios (SPRs) and standardized incidence ratios (SIRs) were used to quantify cancer risks incurred by GIST patients before and after GIST diagnoses, respectively, when compared with the general U.S. population. Of 6,112 GIST patients, 1,047 (17.1%) had additional cancers. There were significant increases in overall cancer rates: 44% (SPR=1.44) before diagnosis and 66% (SIR=1.66) after GIST diagnoses. Malignancies with significantly increased occurrence both before/after diagnoses included other sarcomas (SPR=5.24/SIR=4.02), neuroendocrine-carcinoid tumors (SPR=3.56/SIR=4.79), non-Hodgkin’s lymphoma (SPR=1.69/SIR=1.76), and colorectal adenocarcinoma (SPR=1.51/SIR=2.16). Esophageal adenocarcinoma (SPR=12.0), bladder adenocarcinoma (SPR=7.51), melanoma (SPR=1.46), and prostate adenocarcinoma (SPR=1.20) were significantly more common only before GIST. Ovarian carcinoma (SIR=8.72), small intestine adenocarcinoma (SIR=5.89), papillary thyroid cancer (SIR=5.16), renal cell carcinoma (SIR=4.46), hepatobiliary adenocarcinomas (SIR=3.10), gastric adenocarcinoma (SIR=2.70), pancreatic adenocarcinoma (SIR=2.03), uterine adenocarcinoma (SIR=1.96), non-small cell lung cancer (SIR=1.74), and transitional cell carcinoma of the bladder (SIR=1.65) were significantly more common only after GIST. This is the first population-based study to characterize the associations and temporal relationships between GIST and other cancers, both by site and histological type. These associations may carry important clinical implications for future cancer screening and treatment strategies.