Kobayashi Y, Arimoto H, Ono I, Watanabe S
Epidemiology Division, National Cancer Center Hospital, Tokyo.
Jpn J Clin Oncol. 1990 Jun;20(2):128-33. doi: 10.1093/oxfordjournals.jjco.a039376.
The risk of a person developing a second primary cancer was evaluated in 1,215 patients with laryngeal cancer at the National Cancer Center Hospital. Overall, 92 (8.2%) of the male patients and 5 (5.7%) of the female patients developed a second cancer, compared with 83.0 and 3.7, respectively, expected on the basis of general population rates, resulting observed: expected values (O/E) to be 1.1 and 1.3. The numbers of second cancers of the lung (O/E = 1.9), oropharynx (O/E = 8.8) and esophagus (O/E = 2.8) were significantly in excess of those expected, while the number of second stomach cancers (O/E = 0.5) was far below expectation. Synchronous second cancers were significantly higher than expected (O/E = 4.6). Smoking, especially heavy smoking, was related to second lung cancers, but alcohol drinking featured less. Histories of benign respiratory tract and digestive organ diseases were related to second oropharyngeal cancers. Alcohol drinking was related to second stomach cancers. Radiation therapy for the initial laryngeal cancer was related to second oropharyngeal cancers, while hazardous occupations related to noxious agents for respiratory systems featured more prevalently in cases of second lung cancer. Further analytical studies should clarify the roles of smoking, drinking, occupation and various forms of therapy on the risk of developing a different second cancer following laryngeal cancer.
在国立癌症中心医院，对1215例喉癌患者发生第二原发性癌症的风险进行了评估。总体而言，男性患者中有92例（8.2%）发生了第二种癌症，女性患者中有5例（5.7%）发生了第二种癌症，而根据一般人群发病率预期分别为83.0例和3.7例，由此得出观察值与预期值（O/E）分别为1.1和1.3。肺癌（O/E = 1.9）、口咽癌（O/E = 8.8）和食管癌（O/E = 2.8）的第二种癌症数量显著超过预期，而第二种胃癌的数量（O/E = 0.5）远低于预期。同时性第二种癌症显著高于预期（O/E = 4.6）。吸烟，尤其是重度吸烟，与第二种肺癌有关，但饮酒的关联较小。良性呼吸道和消化器官疾病史与第二种口咽癌有关。饮酒与第二种胃癌有关。初始喉癌的放射治疗与第二种口咽癌有关，而与呼吸系统有害剂相关的有害职业在第二种肺癌病例中更为普遍。进一步的分析研究应阐明吸烟、饮酒、职业和各种治疗形式在喉癌后发生不同第二种癌症风险中的作用。
