Hemminki K, Li X
Department of Biosciences at Novum, Karolinska Institute, 141 57, Huddinge, Sweden.
J Clin Epidemiol. 2001 Apr;54(4):411-6. doi: 10.1016/s0895-4356(00)00331-0.
We used the nationwide Swedish Family-Cancer Database to analyze the risk for soft tissue tumors in offspring by parental cancers and in siblings of soft tissue tumor probands. Additionally, risk for second cancer following soft tissue tumor was investigated. In offspring, 1488 soft tissue tumors were diagnosed between years 1958 and 1996. Groups of offspring were compared by calculating standardized incidence ratios (SIRs) for soft tissue tumors. Parental breast, prostate and connective tissue cancers were associated with offspring soft tissue tumors in sex- and age-specific groups. The SIRs were of borderline significance, suggesting a small etiological contribution by Li-Fraumeni syndrome. Soft tissue tumors conveyed a high risk of second soft tissue tumor, probably partially due to recurrences. However, the observed risk for second nervous system cancer was consistent with Li-Fraumeni syndrome. Other associations were unlikely to be due to Li-Fraumeni or other known syndromes, but they could be spurious findings arising from multiple comparisons. Among these, parental stomach cancer (SIR 3.19, 95% CI 1.69-5.17) and endocrine gland tumors (SIR 3.66, 95% CI 1.32-7.17), particularly parathyroid tumors (SIR 4.46, 95% CI 1.41-9.23), were associated with offspring fibrosarcoma, and parental breast cancers with offspring leiomyosarcoma (SIR 2.04, 95% CI 1.08-3.30).
我们使用瑞典全国性家庭癌症数据库,分析了父母患癌情况下后代患软组织肿瘤的风险,以及软组织肿瘤先证者的兄弟姐妹患软组织肿瘤的风险。此外,还研究了软组织肿瘤后发生第二种癌症的风险。在1958年至1996年期间,后代中诊断出1488例软组织肿瘤。通过计算软组织肿瘤的标准化发病比(SIR),对不同组的后代进行了比较。父母的乳腺癌、前列腺癌和结缔组织癌与特定性别和年龄组的后代软组织肿瘤有关。这些标准化发病比具有临界显著性,提示李-弗劳梅尼综合征的病因学作用较小。软组织肿瘤会带来较高的第二种软组织肿瘤发生风险,这可能部分归因于复发。然而,观察到的第二种神经系统癌症的风险与李-弗劳梅尼综合征一致。其他关联不太可能归因于李-弗劳梅尼综合征或其他已知综合征,但可能是多次比较产生的假阳性结果。其中,父母患胃癌(标准化发病比3.19,95%置信区间1.69 - 5.17)和内分泌腺肿瘤(标准化发病比3.66,95%置信区间1.32 - 7.17),尤其是甲状旁腺肿瘤(标准化发病比4.46,95%置信区间1.41 - 9.23),与后代纤维肉瘤有关,父母患乳腺癌与后代平滑肌肉瘤有关(标准化发病比2.04,95%置信区间1.08 - 3.30)。