Division of Molecular Genetic Epidemiology, German Cancer Research Centre, Heidelberg, Germany.
J Urol. 2011 Jun;185(6):2045-9. doi: 10.1016/j.juro.2011.02.001. Epub 2011 Apr 15.
An increasing incidence and improved prognosis of kidney cancer have led to concern about second primary malignancies. The study of multiple primary malignancies is also important since the association of certain malignancies may guide the search for germline alterations and environmental risk factors. We evaluated bidirectional associations between renal cell carcinoma and other primary cancers.
We studied 8,030 patients with renal cell carcinoma based on the Swedish Family-Cancer Database. The SIR of second cancer was calculated by comparing it to the rate of first cancers. Followup was started in 1993 and continued through 2006.
A total of 677 patients had second cancers after the first renal cell carcinoma, including 89 second renal cell carcinomas. In 776 patients renal cell carcinoma was diagnosed after another primary cancer. Histology concordant renal cell carcinoma pairs showed a SIR of 31.04 and 15.15 after clear cell and total renal cell carcinoma, respectively. The highest SIR of 132.46 was noted for synchronous contralateral clear cell renal cell carcinoma. A reciprocally increased risk of renal cell carcinoma was seen after lung, breast, prostate, bladder, thyroid gland, adrenal gland and nervous system cancer as well as after melanoma and nonHodgkin's lymphoma. Clear cell renal cell carcinoma was also in excess after brain hemangioblastoma with a SIR of 70.79.
High risk was found for histology concordant renal cell carcinoma pairs and contralateral renal cell carcinoma. Bidirectional associations of renal cell carcinoma with many other cancers may imply etiological sharing. von Hippel-Lindau syndrome may explain the excess of renal cell carcinoma after brain hemangioblastoma.
肾癌发病率的增加和预后的改善导致人们对第二原发恶性肿瘤的关注。对多种原发性恶性肿瘤的研究也很重要，因为某些恶性肿瘤的相关性可能有助于寻找种系改变和环境风险因素。我们评估了肾细胞癌与其他原发性癌症之间的双向关联。
我们基于瑞典家族癌症数据库研究了 8030 例肾细胞癌患者。通过与首次癌症的发生率进行比较，计算出第二种癌症的 SIR。随访于 1993 年开始，持续到 2006 年。
共有 677 例患者在首次肾细胞癌后发生了第二种癌症，包括 89 例第二肾细胞癌。在 776 例患者中，肾细胞癌是在另一种原发性癌症后诊断的。组织学一致的肾细胞癌对显示出的 SIR 分别为透明细胞和总肾细胞癌后的 31.04 和 15.15。同步对侧透明细胞肾细胞癌的最高 SIR 为 132.46。肺癌、乳腺癌、前列腺癌、膀胱癌、甲状腺癌、肾上腺癌和神经系统癌症以及黑色素瘤和非霍奇金淋巴瘤后，肾细胞癌的风险也相应增加。透明细胞肾细胞癌在脑血管母细胞瘤后也过多，SIR 为 70.79。
发现组织学一致的肾细胞癌对和对侧肾细胞癌存在高风险。肾细胞癌与许多其他癌症的双向关联可能意味着病因共享。von Hippel-Lindau 综合征可能解释了脑血管母细胞瘤后肾细胞癌的增加。
