Couldwell William T, Cannon-Albright Lisa A
Departments of Neurosurgery and.
J Neurosurg. 2014 Dec;121(6):1474-7. doi: 10.3171/2014.8.JNS132139. Epub 2014 Sep 26.
The cause of most pituitary tumors remains unknown, although a genetic contribution is recognized for some. The prevalence of pituitary tumors in the general population is high. Analyzing the Utah Population Database (UPDB), the authors investigated the co-prevalence of other independent primary tumors in patients with known pituitary tumors, both benign and malignant, and in the relatives of these patients.
The authors identified individuals in the Utah Cancer Registry diagnosed with pituitary tumors who also had genealogy data in the UPDB and then calculated relative risks (RRs) of other tumors in these patients and their relatives.
Among the 591 individuals with pituitary tumors, 16 (2.7%) had a malignant pituitary tumor and 77 (13%) had independent primary tumors of other origin. Overall, this is significantly higher than expected (70.6 expected, p = 0.009) within the general population (RR = 1.32, 95% CI 1.06-1.61). A significant excess for several different cancer sites was observed among the first-, second-, and third-degree relatives of the cases, including prostate and other cancers. Independent primary tumors at other sites have markedly elevated co-prevalence in patients harboring pituitary tumors and among their close and distant relatives.
This information will prove useful for counseling patients in whom pituitary tumors have been diagnosed and suggests strong genetic or environmental co-risks for the development of other tumors.
大多数垂体肿瘤的病因仍不明,尽管已认识到某些肿瘤有遗传因素。垂体肿瘤在普通人群中的患病率较高。通过分析犹他州人口数据库(UPDB),作者调查了已知患有垂体瘤(包括良性和恶性)的患者及其亲属中其他独立原发性肿瘤的共患病率。
作者在犹他州癌症登记处中识别出被诊断患有垂体瘤且在UPDB中有系谱数据的个体,然后计算这些患者及其亲属中其他肿瘤的相对风险(RRs)。
在591例垂体瘤患者中,16例(2.7%)患有恶性垂体瘤,77例(13%)患有其他来源的独立原发性肿瘤。总体而言,这显著高于普通人群中的预期数量(预期为70.6,p = 0.009)(RR = 1.32,95% CI 1.06 - 1.61)。在病例的一级、二级和三级亲属中观察到几种不同癌症部位的显著超额,包括前列腺癌和其他癌症。在患有垂体瘤的患者及其远近亲属中,其他部位的独立原发性肿瘤共患病率明显升高。
这些信息将被证明对已诊断出垂体瘤的患者咨询有用,并提示存在其他肿瘤发生的强烈遗传或环境共同风险。