Zhang Li, Wu Yansheng, Liu Fangfang, Fu Li, Tong Zhongsheng
Department of Breast Oncology, Key Laboratory of Breast Cancer Prevention and Therapy, National Clinical Research Center for Cancer, Tianjin Medical University Cancer Institute and Hospital, Tianjin, P.R.China.
Department of Maxillofacial and Otorhinolaryngology Head and Neck Surgery, National Clinical Research Center for Cancer, Tianjin Medical University Cancer Institute and Hospital, Tianjin, P.R. China.
Oncotarget. 2016 Aug 9;7(32):52450-52459. doi: 10.18632/oncotarget.9547.
Clinical experiences suggest that breast cancer (BC) and thyroid cancer (TC) occur metachronously or synchronously in a patient more frequently than it would by chance. This study was conducted to investigate the clinicopathological characteristics and survival of these double primary malignancies.
18732 patients with first primary BC and 12877 female patients with first primary TC were performed in this retrospective case-controlled study. The control groups were matched with both age at diagnosis and time of surgery (±2 years). The clinicopathological factors, Overall survival (OS), and HRs were evaluated by SPSS.
There were 91(0.49%) BC patients developed metachronous second primary TC (B-T group), and 117 (0.91%) TC patients developed metachronous second primary BC (T-B group).The expression of estrogen and progesterone receptors, and the value of Ki-67, were significantly higher in the B-T group than control. The median value of thyroid globulin antibody (TGAb) and thyroid peroxidase antibody (TPOAb) were higher in T-B group than control (p <0.05). The duration before second primary cancer was shorter for the B-T group than the T-B group (4.09 years vs. 5.82 years, p<0.001). B-T group patients showed poorer survival than BC only patients (p=0.044).
In general, the overall risk of the occurrence of a second primary TC or BC elevated highly in patients with BC or TC. Detailed mechanisms need to be studied to explore the association between these two cancers. Early detection and effective prevention for the first primary BC or TC patients are necessities for reducing the incidence of the second primary cancer and improving the OS.
临床经验表明，乳腺癌（BC）和甲状腺癌（TC）在患者中异时或同时发生的频率高于偶然情况。本研究旨在调查这些双原发恶性肿瘤的临床病理特征和生存率。
本回顾性病例对照研究纳入了18732例首次原发性BC患者和12877例首次原发性TC女性患者。对照组在诊断年龄和手术时间（±2年）上进行匹配。通过SPSS评估临床病理因素、总生存期（OS）和风险比（HRs）。
91例（0.49%）BC患者发生异时性第二原发性TC（B-T组），117例（0.91%）TC患者发生异时性第二原发性BC（T-B组）。B-T组雌激素和孕激素受体表达以及Ki-67值显著高于对照组。T-B组甲状腺球蛋白抗体（TGAb）和甲状腺过氧化物酶抗体（TPOAb）的中位数高于对照组（p<0.05）。B-T组发生第二原发性癌症前的持续时间短于T-B组（4.09年对5.82年，p<0.001）。B-T组患者的生存率低于单纯BC患者（p=0.044）。
总体而言，BC或TC患者发生第二原发性TC或BC的总体风险显著升高。需要研究详细机制以探索这两种癌症之间的关联。对首次原发性BC或TC患者进行早期检测和有效预防是降低第二原发性癌症发病率和改善总生存期的必要措施。
