Departament de Biologia Cellular Fisiologia i Immunologia, Institut de Biotecnologia i de Biomedicina, Universitat Autònoma de Barcelona, Spain.
BJU Int. 2010 Jul;106(1):49-52. doi: 10.1111/j.1464-410X.2009.09081.x. Epub 2009 Nov 17.
Prognosis (case series) Level of Evidence 4.
To estimate the relative risk of developing a second primary neoplasm, in particular lung cancer, after having non-muscle-invasive bladder cancer (NMIBC).
Patients were included in the study if they had developed NMIBC between 1995 and 2003. All clinical data were extracted from the medical records of our institution's database. The interval between neoplasms, smoking habits, histological subtypes and survival were also analysed. Patient follow-up was >or=5 years.
We found 231 patients with NMIBC, 39 of which had a second primary neoplasm: 10 lung cancer, one pancreas, one gastric, one pharynx, one liver, one parathyroid, one oesophageal, five basal cell carcinoma, three larynx, two colon, three rectal and 10 prostate. In patients with lung cancer, NMIBC was the first primary tumour. Overall, the median (range) interval between occurrence of NMIBC and lung cancer was 54.2 (8-168) months. For the relationship between the observed and expected cases of lung cancer, after normalizing our frequencies to the sex ratio and age of our group of patients, the risk of lung cancer was 10.27-fold higher in patients with NMIBC as compared with the general population of Catalonia (95% confidence interval 4.92-18.88).
We consider that an annual examination for the detection and prevention of lung cancer must be included in clinical guides for patients with NMIBC. This proposal is reinforced by the finding that death in our group of patients with both tumours was always derived from lung cancer and not from bladder cancer.
预后（病例系列）证据水平 4.
评估患有非肌肉浸润性膀胱癌（NMIBC）后发生第二原发肿瘤，特别是肺癌的相对风险。
如果患者在 1995 年至 2003 年间患有 NMIBC，则将其纳入研究。所有临床数据均从我们机构数据库的病历中提取。还分析了肿瘤之间的间隔、吸烟习惯、组织学亚型和生存情况。患者随访时间>或=5 年。
我们发现 231 例 NMIBC 患者中有 39 例发生了第二原发肿瘤：10 例肺癌、1 例胰腺癌、1 例胃癌、1 例咽癌、1 例肝癌、1 例甲状旁腺癌、1 例食管癌、5 例基底细胞癌、3 例喉癌、2 例结肠癌、3 例直肠癌和 10 例前列腺癌。在肺癌患者中，NMIBC 是首发肿瘤。总体而言，NMIBC 与肺癌之间的中位（范围）间隔为 54.2（8-168）个月。对于观察到的和预期的肺癌病例之间的关系，在将我们的频率归一化为我们患者组的性别比和年龄后，与加泰罗尼亚普通人群相比，NMIBC 患者的肺癌风险高 10.27 倍（95%置信区间 4.92-18.88）。
我们认为，必须在 NMIBC 患者的临床指南中纳入年度检查以检测和预防肺癌。我们发现，我们这群同时患有两种肿瘤的患者的死亡总是源于肺癌而不是膀胱癌，这一发现加强了这一建议。
