Division of Biostatistics, School of Public Health and Primary Care, Chinese University of Hong Kong, Hong Kong, China.
Cancer Causes Control. 2010 Sep;21(9):1461-6. doi: 10.1007/s10552-010-9574-x. Epub 2010 May 8.
Nasopharyngeal carcinoma (NPC) is rare in most of the world but common among southeast Asians. Since NPC is usually diagnosed at relatively young ages and most patients now survive, the issue of second primary tumors (SPTs) has become important. Previous studies of SPTs among NPC survivors have given conflicting results. Data on patients with NPC diagnosed between 1996 and 2002 were abstracted from the medical records of two Hong Kong oncology centers. SPT incidence in these patients was compared to that of Hong Kong's general population using standardized incidence ratios (SIR). Eight-four patients were observed to have at least 1 SPT and 92 total additional cancers (SIR = 1.93, 95% CI = 1.55-2.37). The excess risk was greater for women and patients under 40 at diagnosis. Significant excesses were found for tongue, lung, nasal and middle ear, and brain cancers. The pattern of sites at which the greatest excess risk occurred is consistent with the hypothesis that much of the excess is due to treatment effects. The greater excess risk among patients diagnosed before 40 points to possible genetic influences. More research is needed to determine the reasons for greater excess risk among women.
鼻咽癌（NPC）在世界上大多数地区较为罕见，但在东南亚地区较为常见。由于 NPC 通常在相对年轻的时候被诊断出来，而且大多数患者现在都能存活，因此二次原发肿瘤（SPT）的问题变得很重要。以前对 NPC 幸存者 SPT 的研究结果存在矛盾。从香港两个肿瘤中心的病历中提取了 1996 年至 2002 年间诊断的 NPC 患者的数据。使用标准化发病率比（SIR）将这些患者的 SPT 发生率与香港一般人群进行比较。84 例患者至少有 1 个 SPT 和 92 个其他癌症（SIR=1.93，95%CI=1.55-2.37）。女性和诊断时年龄小于 40 岁的患者风险增加更多。对于舌、肺、鼻和中耳以及脑癌，风险增加更为显著。风险增加最大的部位模式与治疗效果导致大部分风险增加的假设一致。40 岁之前诊断出的患者风险增加更多，可能与遗传因素有关。需要进一步研究以确定女性风险增加更多的原因。
