Goggins William, Daniels Gilbert H, Tsao Hensin
Centre for Epidemiology and Biostatistics, School of Public Health, Chinese University of Hong Kong, Hong Kong, China.
Int J Cancer. 2006 Jan 1;118(1):185-8. doi: 10.1002/ijc.21300.
Recent molecular studies have identified recurrent BRAF mutations in both cutaneous melanoma and thyroid malignancies. This relatively selective shared genetic vulnerability raises the possibility that these 2 tumors are connected through a common undisclosed pathogenic mechanism. To assess for possible associations between these 2 genetically related tumors at the population level, we calculated standardized incidence ratios (SIRs) for thyroid cancer (TC) among cutaneous melanoma (CM) survivors and CM among TC survivors using the National Cancer Institute's Surveillance, Epidemiology and End Result (SEER) database. Between 1973 and 2000, there were 73,274 and 27,138 cases of CM and TC cases, respectively. Overall, we found a 2.17-fold increase (p < 0.0000001) in the risk of TC after a diagnosis of CM. This augmented risk of TC is somewhat higher for males, for those diagnosed more recently and for the first 3 years after the CM diagnosis. We also detected a considerably smaller and borderline significant increased risk of CM (25%, p = 0.063) among the post-TC survivors. Of note, TC patients who received radiation therapy had a 57% increased risk of a subsequent CM (p = 0.034). Our study documents a strong unilateral risk of TC after CM. More studies are clearly needed to better delineate this mechanism.
最近的分子研究已在皮肤黑色素瘤和甲状腺恶性肿瘤中发现了复发性BRAF突变。这种相对具有选择性的共同基因易感性增加了这两种肿瘤通过一种尚未揭示的共同致病机制相联系的可能性。为了在人群水平评估这两种基因相关肿瘤之间可能存在的关联，我们使用美国国立癌症研究所的监测、流行病学和最终结果（SEER）数据库，计算了皮肤黑色素瘤（CM）幸存者中甲状腺癌（TC）以及TC幸存者中CM的标准化发病比（SIR）。1973年至2000年期间，分别有73274例CM病例和27138例TC病例。总体而言，我们发现CM诊断后TC风险增加了2.17倍（p < 0.0000001）。男性、近期诊断的患者以及CM诊断后的前3年中，TC的这种增加风险略高。我们还在TC后幸存者中检测到CM风险有相当小且接近显著的增加（25%，p = 0.063）。值得注意的是，接受放射治疗的TC患者后续发生CM的风险增加了57%（p = 0.034）。我们的研究记录了CM后发生TC的强烈单侧风险。显然需要更多研究来更好地阐明这种机制。
