Association of ampullary and colorectal malignancies
Association of ampullary and colorectal malignancies
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作者：
Das, A;Neugut, AI;Chak, A
背景由于壶腹癌和结直肠癌之间在致癌作用和自然史方面的相似性，作者研究了壶腹癌和结直肠癌是否以增加的比率发生在同一个体中。我们使用了国家癌症研究所监测、流行病学和最终结果（SEER）计划1973年1月至1999年12月期间的数据。壶腹癌（或结直肠癌）患者的随访人年用于计算结直肠癌（或壶腹癌）作为第二原发恶性肿瘤的预期病例数。使用Byar限值并假设泊松分布计算标准化发病率比（SIR）及其95%置信区间（CI）。作者确定了2043例白色壶腹癌患者，这些患者在1973年至1999年期间被纳入SEER登记研究。在总计5674人-年的随访中，30例患者（预期为14例）发生结直肠癌，总体SIR为2.14（95%CI，1.45-3.06）。同样，在总计1，270，255人-年的随访中，262，066例白色结直肠癌患者中有57例发生壶腹癌，SIR为2.18（95%CI，1.69-2.85）。壶腹癌患者发生第二原发性结直肠恶性肿瘤的风险增加，结直肠癌患者发生第二原发性壶腹恶性肿瘤的风险增加。这些发现表明壶腹和结直肠。恶性肿瘤具有共同的环境和/或遗传风险因素。
BACKGROUND. Because of the similarities in terms of carcinogenesis and natural history between cancer of the ampulla of Vater and colorectal cancer, the authors examined whether ampullary and colorectal malignancies occur in the same individuals at increased rates.METHODS. We used data from the Surveillance, Epidemiology, and End,Results (SEER) Program of the National Cancer Institute for the period from January 1973 through December 1999. Person-years of follow-up for patients with ampullary (or colorectal) cancer were used to calculate the expected number of cases of colorectal (or ampullary) cancer as a second primary malignancy. Standardized incidence ratios (SIRs) with 95% confidence intervals (CIs) were calculated using Byar limits and assuming a Poisson distribution.RESULTS. The authors identified 2043 white patients with ampullary cancer who were included in the SEER registry between 1973 and 1999. Over an aggregate 5674 person-years of follow-up, 30 patients, compared with an expected 14, developed colorectal cancer, yielding an overall SIR of 2.14 (95% Cl, 1.45-3.06). Similarly, 57 of 262,066 white patients with colorectal cancer developed ampullary cancer over an aggregate, 1,270,255 person-years of follow-up, yielding an SIR of 2.18 (95% Cl, 1.69-2.85).CONCLUSIONS. Patients with ampullary cancer are at increased risk for a second primary colorectal malignancy, and patients with colorectal cancer are at increased risk for a second primary ampullary malignancy. These findings suggest that ampullary and colorectal. malignancies share common environmental and/or genetic risk factors.