Roychoudhuri Rahul, Putcha Venkata, Møller Henrik
Thames Cancer Registry, Division of Cancer Studies, Guy's, King's and St. Thomas' School of Medicine, London, SE1 3QD, UK.
Cancer Causes Control. 2006 Jun;17(5):655-62. doi: 10.1007/s10552-005-0615-9.
The human body displays marked asymmetry: paired organs differ bilaterally exerting effects upon cancer incidence and progression. However the factors involved remain contentious. In this large study involving over a quarter of a million cancer patients, we examine the epidemiological correlates of cancer laterality including incidence, stage at diagnosis and survival in the five major paired organs: the breasts, lungs, kidneys, testes and ovaries.
Cancer patients were selected from the Thames Cancer Registry database and age-standardised incidence rates (ASRs), stage distribution at diagnosis and survival rates computed, stratifying appropriately.
Cancer incidence differed significantly by laterality at all sites studied (p < 0.01) but substantially in the lung (left-right incidence-rate ratio [IRR] 0.87), breast (IRR 1.07), testis (IRR 0.87) and in ovarian cancer (IRR 0.86). Autopsy data showed strongly coincident left-right organ size ratios (0.87 in the lungs and 0.87 in the testes). Patients with left testicular cancer, right lung cancer and left ovarian cancer showed significantly better survival than those with contralateral disease (p < 0.05).
In the lungs and testes, asymmetries in cancer incidence closely coincided with asymmetries in organ size. Our results suggest that tissue mass in these organs is an important contributor to asymmetry in cancer incidence.
人体表现出明显的不对称性：成对器官在双侧存在差异，这对癌症的发生和进展产生影响。然而，其中涉及的因素仍存在争议。在这项涉及超过25万名癌症患者的大型研究中，我们研究了癌症侧别在五个主要成对器官（乳房、肺、肾、睾丸和卵巢）中的流行病学关联，包括发病率、诊断时的分期和生存率。
从泰晤士癌症登记数据库中选取癌症患者，并计算年龄标准化发病率（ASRs）、诊断时的分期分布和生存率，并进行适当分层。
在所研究的所有部位，癌症发病率在侧别上存在显著差异（p < 0.01），但在肺（左右发病率比[IRR] 0.87）、乳房（IRR 1.07）、睾丸（IRR 0.87）和卵巢癌（IRR 0.86）中差异尤为明显。尸检数据显示左右器官大小比例高度一致（肺为0.87，睾丸为0.87）。左侧睾丸癌、右侧肺癌和左侧卵巢癌患者的生存率显著高于对侧疾病患者（p < 0.05）。
在肺和睾丸中，癌症发病率的不对称性与器官大小的不对称性密切相关。我们的结果表明，这些器官中的组织质量是癌症发病率不对称性的重要因素。
