Department of Gastroenterology, Sandwell General Hospital, Lyndon, West Bromwich, UK.
Eur J Cancer Prev. 2010 May;19(3):182-5. doi: 10.1097/CEJ.0b013e3283372137.
Oesophageal adenocarcinoma (OAC) is less common and develops at a later age in women compared with men. Endogenous oestrogen may therefore protect against OAC development. A cohort of women with breast cancer, a tumour commonly treated with oestrogen antagonists, was examined to identify the subsequent risk of developing OAC. Earlier studies have implicated radiotherapy in increasing oesophageal cancer (OC) risk among women with breast cancer. West Midlands Cancer Intelligence Unit data recording cancer diagnosis and treatment information was examined to identify patients with a first malignant primary breast cancer during 1977-2004. Patients were followed until diagnosis of a second primary cancer, death or end of the time period examined. Age-adjusted and period-adjusted standardized incidence ratios (SIR) were calculated as an estimate of relative risk for a second primary OC. Seventy-three thousand six hundred and thirteen women were eligible for the study, providing 486 679 person years at risk for analysis. One hundred and thirty-two second primary OCs were observed, compared with 121 expected (SIR 1.09; 95% confidence interval: 0.91-1.29). Radiotherapy treatment in 37 888 women did not affect the risk of a second primary OC (SIR 1.07; 95% confidence interval: 0.79-1.41). No difference was identified when examined by OC morphology.There was no association between breast cancer and a second primary OC. Radiotherapy that avoids deep irradiation in the treatment of breast cancer, local nodes or recurrence was not associated with an increased risk of developing a second primary OC.
食管腺癌（OAC）在女性中比男性少见，发病年龄也较晚。因此，内源性雌激素可能对 OAC 的发生有保护作用。本研究对一组患有乳腺癌的女性进行了研究，乳腺癌是一种常用雌激素拮抗剂治疗的肿瘤，以确定其随后发生 OAC 的风险。先前的研究表明，放射治疗会增加女性乳腺癌患者患食管癌（OC）的风险。本研究通过审查西米德兰兹癌症情报单位记录的癌症诊断和治疗信息，以确定 1977 年至 2004 年期间首次患有恶性原发性乳腺癌的患者。对患者进行随访，直至诊断出第二原发癌、死亡或研究时间段结束。年龄调整和时期调整后的标准化发病率比（SIR）用于估计第二原发 OC 的相对风险。共有 73613 名女性符合研究条件，为分析提供了 486679 人年的风险。观察到 132 例第二原发 OAC，而预期为 121 例（SIR 为 1.09；95%置信区间：0.91-1.29）。在 37888 名接受放射治疗的女性中，放射治疗并未影响第二原发 OC 的风险（SIR 为 1.07；95%置信区间：0.79-1.41）。按 OC 形态学检查也没有差异。乳腺癌与第二原发 OC 之间没有关联。在治疗乳腺癌、局部淋巴结或复发时避免深部照射的放射治疗与发生第二原发 OC 的风险增加无关。
