Norberg Lars, Johansson Robert, Rasmuson Torgny
Department of Radiation Sciences, Oncology, Umeå University, Umeå, Sweden.
Clin Endocrinol (Oxf). 2008 May;68(5):780-5. doi: 10.1111/j.1365-2265.2007.03118.x. Epub 2007 Nov 2.
To present the incidence of pituitary adenomas in northern Sweden and to determine whether the incidence of second primary tumours differs from the incidence in the general population or might be related to radiotherapy.
A retrospective register study.
A total of 546 patients with pituitary adenomas were identified in the Cancer Registry of northern Sweden between 1958 and 2004. Only patients with histopathological verification and/or endocrine activity of the adenoma and more than 12 months of follow-up were included, resulting in 376 patients in the study.
The number of patients receiving surgery and/or radiotherapy and presenting second primary tumours were registered. Standard incidence ratios (SIRs) between the observed and the expected incidence of second primary tumours were calculated.
The total number of person-years at risk for a second primary tumour was 4730. Fifty-four out of 376 (14%) patients had 63 second primary tumours. Forty patients had second primary tumours diagnosed more than 12 months after diagnosis of the pituitary adenoma (expected 42.6, SIR 0.94, 95% CI 0.67-1.28). A significantly increased incidence of second primary tumours was seen in 42 men with GH-secreting adenomas. Ten second tumours were found (expected 4.55, SIR 2.20, 95% CI 1.05-4.04). A total of 261 patients received radiotherapy and 31 second primary tumours occurred after radiotherapy (expected 32.9, SIR 0.94, 95% CI 0.64-1.34). Three second primary intracranial tumours appeared within the irradiation volume (expected 0.85, SIR 3.51, 95% CI 0.71-10.36).
No significant increase was found in the incidence of second primary tumours in general in patients with pituitary adenomas. An increased incidence of second primary tumours was seen in men with GH-secreting adenomas.
呈现瑞典北部垂体腺瘤的发病率，并确定第二原发性肿瘤的发病率是否与普通人群不同，或者是否可能与放疗有关。
一项回顾性登记研究。
1958年至2004年期间，在瑞典北部癌症登记处共识别出546例垂体腺瘤患者。仅纳入腺瘤有组织病理学证实和/或内分泌活性且随访超过12个月的患者，最终研究中有376例患者。
记录接受手术和/或放疗且出现第二原发性肿瘤的患者数量。计算第二原发性肿瘤的观察发病率与预期发病率之间的标准化发病率（SIR）。
发生第二原发性肿瘤的总人年数为4730。376例患者中有54例（14%）出现63例第二原发性肿瘤。40例患者在垂体腺瘤诊断超过12个月后被诊断出第二原发性肿瘤（预期42.6例，SIR 0.94，95%置信区间0.67 - 1.28）。在42例生长激素分泌型腺瘤男性患者中，第二原发性肿瘤的发病率显著增加。发现10例第二原发性肿瘤（预期4.55例，SIR 2.20，95%置信区间1.05 - 4.04）。共有261例患者接受了放疗，放疗后出现31例第二原发性肿瘤（预期32.9例，SIR 0.94，95%置信区间0.64 - 1.34）。在照射区域内出现3例第二原发性颅内肿瘤（预期0.85例，SIR 3.51，95%置信区间0.71 - 10.36）。
总体而言，垂体腺瘤患者中第二原发性肿瘤的发病率未发现显著增加。生长激素分泌型腺瘤男性患者的第二原发性肿瘤发病率有所增加。
