小肠癌：1992 年至 2006 年美国基于人群的发病率和生存模式研究。
Small intestinal cancer: a population-based study of incidence and survival patterns in the United States, 1992 to 2006.
机构信息
Department of Veterans Affairs Medical Center, Medical Service (111), 921 Northeast 13th Street, Oklahoma City, OK 73104, USA.
出版信息
Cancer Epidemiol Biomarkers Prev. 2010 Aug;19(8):1908-18. doi: 10.1158/1055-9965.EPI-10-0328. Epub 2010 Jul 20.
BACKGROUND
The etiology of cancers of the small intestine is largely unknown. To gain insight into these rare malignancies, we evaluated contemporaneous incidence and survival patterns.
METHODS
Using small intestine cancer data from 12 population-based registries of the Surveillance, Epidemiology and End Results Program, we calculated age-adjusted and age-specific incidence rates (IRs), IR ratios, and relative survival (RS) rates.
RESULTS
In total, 10,945 small intestine cancers (IR = 2.10/100,000 person-years) were diagnosed during 1992 to 2006, including carcinomas (n = 3,412; IR = 0.66), neuroendocrine cancers (n = 4,315; IR = 0.83), sarcomas (n = 1,084; IR = 0.20), and lymphomas (n = 2,023, IR = 0.38). For all histologic groups, males had significantly higher IRs than females, and distinct age-specific gender patterns were limited to intermediate-/high-grade lymphomas. Neuroendocrine cancer rates varied significantly by race, with rates highest among blacks and lowest among Asians/Pacific Islanders. Carcinoma IRs were highest among blacks; sarcoma IRs were highest among Asians/Pacific Islanders; and lymphoma IRs were highest among whites. Age-specific IR patterns were similar across racial/ethnic groups. During 1992 to 2006, duodenal cancer IRs increased more markedly than those for other subsites. RS varied little by gender or race. Neuroendocrine cancers had the most favorable RS, and carcinomas had the least favorable. The greatest improvement in 5-year RS from 1992 to 1998 to 1999 to 2005 was observed for sarcomas and lymphomas.
CONCLUSIONS
Distinct small intestine cancer IR patterns according to histologic subtype suggest different underlying etiologies and/or disease biology, with susceptibility varying by gender, racial/ethnic groups, and subsite. Temporal patterns support a possible role for diagnostic bias of duodenal cancers.
IMPACT
Future epidemiologic studies of small intestine cancer should consider histologic subtype by gender, race/ethnicity, and subsite.
背景
小肠癌的病因在很大程度上是未知的。为了深入了解这些罕见的恶性肿瘤，我们评估了同期的发病率和生存模式。
方法
使用来自监测、流行病学和最终结果计划（SEER）的 12 个人群基础登记处的小肠癌数据，我们计算了年龄调整和年龄特异性发病率（IR）、IR 比和相对生存率（RS）。
结果
在 1992 年至 2006 年期间，共诊断出 10945 例小肠癌（IR=2.10/100000 人年），包括癌（n=3412；IR=0.66）、神经内分泌癌（n=4315；IR=0.83）、肉瘤（n=1084；IR=0.20）和淋巴瘤（n=2023，IR=0.38）。对于所有组织学类型，男性的发病率均高于女性，而不同性别之间的年龄特异性模式仅限于中/高级别淋巴瘤。不同种族之间神经内分泌癌的发病率存在显著差异，发病率最高的是黑人，最低的是亚洲/太平洋岛民。癌的发病率在黑人中最高；肉瘤的发病率在亚洲/太平洋岛民中最高；而淋巴瘤的发病率在白人中最高。年龄特异性发病率模式在不同种族/族裔群体中相似。在 1992 年至 2006 年期间，十二指肠癌的发病率增长明显高于其他部位。性别和种族对 RS 的影响不大。神经内分泌癌的 RS 最好，癌的 RS 最差。从 1992 年至 1998 年至 1999 年至 2005 年，肉瘤和淋巴瘤的 5 年 RS 改善最大。
结论
根据组织学亚型的不同小肠癌发病率模式表明不同的潜在病因和/或疾病生物学，易感性因性别、种族/族裔和部位而异。时间模式支持十二指肠癌诊断偏差可能起作用。
影响
未来对小肠癌的流行病学研究应考虑按性别、种族/族裔和部位划分的组织学亚型。
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