Hyperparathyroidism and subsequent cancer risk in Denmark
Hyperparathyroidism and subsequent cancer risk in Denmark
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DOI：
10.1002/cncr.10846
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发表时间：
2002-10-15
期刊：
影响因子：
6.2
通讯作者：
Brinton, LA
中科院分区：
文献类型：
--
作者：
Pickard, AL;Gridley, G;Brinton, LA
背景有越来越多的证据表明，甲状旁腺功能亢进（HPT），一种导致血清钙水平升高的疾病，与内分泌肿瘤和其他恶性肿瘤有关，提示HPT和癌症之间可能存在因果关系。为了调查HPT与随后癌症风险的关系，作者对丹麦医院诊断为HPT的2425例患者进行了记录关联研究。在出院记录中确定患者，然后将1977-1993年的记录与丹麦国家癌症登记处联系起来，以确定癌症发病率。为了估计癌症风险，计算标准化发病率（SIR）。在排除第一年随访中确诊的患者后，共观察到219例恶性肿瘤，SIR为1.25（95%置信区间[95%CI]，1.1-1.4）。女性患癌症的风险高于男性。在原发性（特发性）HPT患者中，造血系统恶性肿瘤显著升高（SIR，1.88; 95%CI，1.0-3.2;基于13例患者），过量主要来自4例观察到的多发性骨髓瘤患者。继发性HPT患者总体癌症风险增加不显著。被诊断为其他或未指明类型的HPT的患者的尿路癌（SIR，2.71; 95%CI，1.2-5.3;基于8例患者）和甲状腺癌（SIR，21.19; 95%CI，4.3-61.9;基于3例患者）显著增加。未来的研究应监测与HPT相关的特定内分泌改变是否可能影响造血、甲状腺和尿路癌的长期风险。
BACKGROUND. There is increasing evidence that hyperparathyroidism (HPT), a condition that leads to elevated serum calcium levels, is associated with endocrine and other malignancies, suggesting a possible causal link between HPT and carcinoma.METHODS. To investigate the relation of HPT to subsequent cancer risk, the authors conducted a record-linkage study among 2425 patients who were diagnosed with HPT in Danish hospitals. Patients were identified in hospital discharge records, and records were then linked with the Danish National Cancer Registry for the years 1977-1993 to identify cancer incidence. To estimate cancer risk, standardized incidence ratios (SIRs) were computed.RESULTS. After excluding patients who were diagnosed in the first year of follow-up, a total of 219 malignancies were observed, resulting in an SIR of 1.25 (95% confidence interval [95%CI], 1.1-1.4). Cancer risk among women was higher than among men. Among those with primary (idiopathic) HPT, hematopoetic malignancies were elevated significantly (SIR, 1.88; 95%CI, 1.0-3.2; based on 13 patients), with the excess derived primarily from 4 observed patients with multiple myeloma. Patients with secondary HPT had an insignificantly increased risk of overall cancers. Patients who were diagnosed with other or unspecified types of HPT had significant increases in carcinoma of the urinary tract (SIR, 2.71; 95%Cl, 1.2-5.3; based on 8 patients) and carcinoma of the thyroid gland (SIR, 21.19; 95%Cl, 4.3-61.9; based on 3 patients).CONCLUSIONS. Future studies should monitor whether specific endocrine alterations associated with HPT may affect the long-term risk of hematopoetic, thyroid, and urinary tract carcinomas.