Department of Cardiothoracic Surgery, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania 15213, USA.
Ann Thorac Surg. 2012 Mar;93(3):884-8. doi: 10.1016/j.athoracsur.2011.05.089. Epub 2011 Oct 1.
Patients with thymoma may have a predisposition toward extrathymic neoplasia. To understand the lifetime risk and incidence of extrathymic neoplasia in patients with thymoma, we evaluated extrathymic neoplasms diagnosed either before or after the diagnosis of thymoma.
We queried the Surveillance, Epidemiology, and End Results (SEER) cancer database and identified patients with thymoma and extrathymic neoplasms. We collected demographic and treatment data, calculated the incidence of each extrathymic neoplasm (adjusting for age), and compared the incidence of extrathymic neoplasm in patients with thymoma with the age-adjusted incidence in the SEER database general population.
Of 2,171 patients with thymoma in the SEER database, 306 (14.1%) had extrathymic primary cancers. Extrathymic neoplasms were diagnosed before the diagnosis of thymoma in 88 patients and after the diagnosis of thymoma in 206 patients. In 12 patients, separate extrathymic neoplasms were diagnosed both before and after thymoma diagnosis. The incidence of extrathymic cancers in patients with thymoma (8,224 per 100,000 persons) was significantly higher than in the SEER general population (459 per 100,000 persons; p<0.001). The standardized incidence ratio for extrathymic cancer was also significantly increased, in particular for lymphomas, leukemias, esophageal cancer, and lung cancer. Increased age at diagnosis (p<0.001), longer survival after diagnosis (p<0.001), and male sex (p=0.041)-but not radiation therapy or surgery-were significant risk factors for the development of extrathymic cancers in patients with thymoma.
The incidence of extrathymic neoplasia is significantly higher in patients with thymoma than in the general population and occurs both before and after the diagnosis of thymoma.
胸腺瘤患者可能存在发生胸外肿瘤的倾向。为了了解胸腺瘤患者发生胸外肿瘤的终生风险和发病率，我们评估了在诊断为胸腺瘤之前或之后诊断出的胸外肿瘤。
我们查询了监测、流行病学和最终结果（SEER）癌症数据库，并确定了患有胸腺瘤和胸外肿瘤的患者。我们收集了人口统计学和治疗数据，计算了每种胸外肿瘤的发病率（根据年龄调整），并将胸腺瘤患者的胸外肿瘤发病率与 SEER 数据库一般人群的年龄调整发病率进行了比较。
在 SEER 数据库中，有 2171 例胸腺瘤患者，其中 306 例（14.1%）患有胸外原发性癌症。胸外肿瘤在 88 例患者中先于胸腺瘤诊断，在 206 例患者中后于胸腺瘤诊断。在 12 例患者中，分别在胸腺瘤诊断前后诊断出了不同的胸外肿瘤。胸腺瘤患者的胸外癌症发病率（每 100000 人中有 8224 例）显著高于 SEER 一般人群（每 100000 人中有 459 例；p<0.001）。胸外癌症的标准化发病率比值也显著增加，尤其是淋巴瘤、白血病、食管癌和肺癌。诊断时年龄较大（p<0.001）、诊断后生存时间较长（p<0.001）和男性（p=0.041）-而非放疗或手术-是胸腺瘤患者发生胸外癌症的显著危险因素。
胸腺瘤患者的胸外肿瘤发病率明显高于一般人群，并且在诊断为胸腺瘤之前和之后都有发生。
