Renal Cell Carcinoma as First and Second Primary Cancer: Etiological Clues From the Swedish Family-Cancer Database
Renal Cell Carcinoma as First and Second Primary Cancer: Etiological Clues From the Swedish Family-Cancer Database
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DOI：
10.1016/j.juro.2011.02.001
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发表时间：
2011-06-01
影响因子：
6.6
通讯作者：
Sundquist, Jan
中科院分区：
文献类型：
--
作者：
Liu, Hao;Hemminki, Kari;Sundquist, Jan
目的：肾癌发病率的增加和预后的改善已引起人们对第二原发癌的关注。多原发恶性肿瘤的研究也很重要，因为某些恶性肿瘤的相关性可能会指导寻找生殖系改变和环境风险因素。我们评估了肾癌和其他原发癌症之间的双向关联。材料和方法：我们基于瑞典家庭癌症数据库研究了8030例肾癌患者。第二次癌症的SIR是通过与第一次癌症的比率进行比较来计算的。结果：共有677例患者发生了继第一次肾细胞癌之后的第二次肿瘤，其中89例为第二次肾细胞癌。在776例患者中，肾细胞癌是在另一种原发癌症之后被诊断出来的。组织学符合的肾细胞癌对在透明细胞癌和全肾细胞癌后的SIR分别为31.04和15.15。同步对侧肾透明细胞癌的SIR最高，为132.46。在肺癌、乳腺癌、前列腺癌、膀胱癌、甲状腺癌、肾上腺癌和神经系统癌之后，以及在黑色素瘤和非霍奇金淋巴瘤之后，肾细胞癌的风险也会相应增加。肾透明细胞癌也是脑血管母细胞瘤后的高发肿瘤，SIR为70.79。结论：肾透明细胞癌是组织学符合的肾细胞癌对和对侧肾细胞癌的高危因素。肾细胞癌与许多其他癌症的双向关联可能意味着病因相同。Von Hippel-Lindau综合征可能解释了脑血管母细胞瘤后肾细胞癌的过度发生。
Purpose: An increasing incidence and improved prognosis of kidney cancer have led to concern about second primary malignancies. The study of multiple primary malignancies is also important since the association of certain malignancies may guide the search for germline alterations and environmental risk factors. We evaluated bidirectional associations between renal cell carcinoma and other primary cancers.Materials and Methods: We studied 8,030 patients with renal cell carcinoma based on the Swedish Family-Cancer Database. The SIR of second cancer was calculated by comparing it to the rate of first cancers. Followup was started in 1993 and continued through 2006.Results: A total of 677 patients had second cancers after the first renal cell carcinoma, including 89 second renal cell carcinomas. In 776 patients renal cell carcinoma was diagnosed after another primary cancer. Histology concordant renal cell carcinoma pairs showed a SIR of 31.04 and 15.15 after clear cell and total renal cell carcinoma, respectively. The highest SIR of 132.46 was noted for synchronous contralateral clear cell renal cell carcinoma. A reciprocally increased risk of renal cell carcinoma was seen after lung, breast, prostate, bladder, thyroid gland, adrenal gland and nervous system cancer as well as after melanoma and nonHodgkin's lymphoma. Clear cell renal cell carcinoma was also in excess after brain hemangioblastoma with a SIR of 70.79.Conclusions: High risk was found for histology concordant renal cell carcinoma pairs and contralateral renal cell carcinoma. Bidirectional associations of renal cell carcinoma with many other cancers may imply etiological sharing. von Hippel-Lindau syndrome may explain the excess of renal cell carcinoma after brain hemangioblastoma.