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大涎腺癌后的第二原发癌。

Second primaries after major salivary gland cancer.

机构信息

Department of Otolaryngology–Head and Neck Surgery, The New York Eye and Ear Infirmary, New York, New York 10003, USA.

出版信息

Otolaryngol Head Neck Surg. 2011 Aug;145(2):254-8. doi: 10.1177/0194599811402899.

DOI:10.1177/0194599811402899
PMID:21493280
Abstract

OBJECTIVES

To evaluate the risk of second primary cancers in patients with major salivary gland cancer using a large population database and to examine the effects of sex, salivary gland cancer histology, and radiation therapy on the risk of second primaries.

STUDY DESIGN

Population-based study using the Surveillance, Epidemiology, and End Result (SEER) cancer database.

SUBJECT AND METHODS

The subjects were 15,572 men and women ages 15 and above, diagnosed with cancer of the major salivary glands from 1973 to 2006.

RESULTS

There was an increased risk of oral cavity (standardized incidence ratio [SIR] = 3.48, P < .05), salivary (SIR = 9.97, P < .05), lung and bronchus (SIR = 1.60, P < .05), kidney (SIR = 1.68, P < .05), and thyroid (SIR = 2.66, P < .05) cancers. Men had an increased risk of developing kidney cancer (SIR = 1.70, P < .05) compared with women (SIR = 1.64, P > .05). Patients with mucoepidermoid carcinoma had an increased risk of a second salivary gland cancer (SIR = 8.97, P < .05) and thyroid cancer (SIR = 3.97, P < .05). Patients with adenoid cystic carcinoma had an increased risk of oral cavity (SIR = 3.76, P < .05) and nasopharyngeal (SIR = 16.88, P < .05) cancers. Patients with acinar cell carcinoma had an increased risk of salivary (SIR = 31.36, P < .05), kidney (SIR = 2.98, P < .05), and thyroid (SIR = 3.85, P < .05) cancers. Patients who received radiation therapy had a higher incidence of lung and bronchus (SIR = 2.11, P < .05), laryngeal (SIR = 3.08, P < .05), and thyroid (SIR = 2.95, P < .05) cancers compared with patients who did not receive radiation therapy (SIR = 1.18, 0.48, and 2.39, respectively; P > .05). Patients had an increased risk of developing second primaries, even 10 years after diagnosis of primary salivary gland cancer.

CONCLUSIONS

Patients with major salivary gland cancers are at a risk for certain second primary cancers. This highlights the need for long-term surveillance in these patients, not only for recurrence but also for second primary cancers.

摘要

目的

利用大型人群数据库评估大涎腺癌患者发生第二原发癌的风险，并探讨性别、涎腺癌组织学和放疗对第二原发癌风险的影响。

研究设计

利用监测、流行病学和最终结果（SEER）癌症数据库进行的基于人群的研究。

研究对象

1973 年至 2006 年间，年龄在 15 岁及以上被诊断患有大涎腺癌的 15572 名男女患者。

结果

口腔（标准化发病比 [SIR] = 3.48，P <.05）、涎腺（SIR = 9.97，P <.05）、肺和支气管（SIR = 1.60，P <.05）、肾（SIR = 1.68，P <.05）和甲状腺（SIR = 2.66，P <.05）癌症的风险增加。与女性（SIR = 1.64，P >.05）相比，男性发生肾癌（SIR = 1.70，P <.05）的风险增加。黏液表皮样癌患者发生第二涎腺癌（SIR = 8.97，P <.05）和甲状腺癌（SIR = 3.97，P <.05）的风险增加。腺样囊性癌患者发生口腔癌（SIR = 3.76，P <.05）和鼻咽癌（SIR = 16.88，P <.05）的风险增加。腺泡细胞癌患者发生涎腺癌（SIR = 31.36，P <.05）、肾癌（SIR = 2.98，P <.05）和甲状腺癌（SIR = 3.85，P <.05）的风险增加。接受放疗的患者发生肺癌和支气管癌（SIR = 2.11，P <.05）、喉癌（SIR = 3.08，P <.05）和甲状腺癌（SIR = 2.95，P <.05）的风险高于未接受放疗的患者（SIR = 1.18、0.48 和 2.39，分别；P >.05）。即使在原发性涎腺癌诊断后 10 年，患者仍有发生第二原发癌的风险。

结论

大涎腺癌患者存在某些第二原发癌的风险。这突出表明需要对这些患者进行长期监测，不仅是为了复发，还为了第二原发癌。

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