Emerging molecular technologies for identifying the risk of second cancers.
Emerging molecular technologies for identifying the risk of second cancers.
复制标题
新兴的分子技术来识别第二癌的风险。
DOI：
10.1158/1940-6207.capr-09-0101
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发表时间：
2009-07
期刊：
影响因子：
--
通讯作者：
Gruber SB
中科院分区：
文献类型：
--
作者：
Mayne ST;Gruber SB
Cancer is becoming an increasingly survivable disease, and the number of cancer survivors is increasing each year. Second or higher-order cancers now account for about 16% of incident cancers in the Surveillance, Epidemiology, and End Results database (1). An important current research need is to understand which patients are at greatest risk for second cancers and, thus, the greatest potential beneficiaries of available or experimental targeted surveillance and chemoprevention strategies.Research over the past decade has emphasized the development of cancer risk models based on host characteristics (eg, age, sex, reproductive factors), exogenous exposures (eg, human papillomavirus, environmental tobacco smoke), lifestyle factors (eg, smoking, alcohol), and (for second cancers) tumor characteristics (eg, disease site, stage). These models have moved the field of cancer risk prediction forward with regard to both first and second cancers. In this issue of the journal, the field moves forward again with the report of Wu et al.(2), which examines a large number of gene polymorphisms in relation to the risk of second primary tumors/local recurrence in patients who have been curatively treated for early-stage squamous cell carcinomas of the oral cavity, pharynx, and larynx, the first large-scale evaluation of this type in head and neck cancer patients. The results are striking. The authors offer data supporting the hypothesis that risk prediction significantly and substantially improves following the incorporation of genetic data (multiple risk loci) into prediction models and that second cancers are partially attributable to polygenic variation, as has been clearly shown for first primary head and neck cancers (3). Squamous cell carcinoma of the head and neck has been a model disease site for research in second primary prevention for several reasons. Patients with early-stage disease frequently are treated curatively, surviving their disease to be at risk for second cancers. The annual risk for second primary cancers is 5% among stage I/II patients (4). Second cancers and local recurrences are a major cause of morbidity and mortality in this patient population (4). Various chemopreventive ap-
