Oweira Hani, Schmidt Jan, Helbling Daniel, Petrausch Ulf, Schöb Othmar, Mehrabi Arianeb, Giryes Anwar, Elhadedy Hazem, Abdel-Rahman Omar
a Surgery , Swiss Cancer Institute , Cham , Switzerland.
b Department of General, Visceral and Transplant Surgery , University of Heidelberg , Heidelberg , Germany.
Expert Rev Gastroenterol Hepatol. 2017 Sep;11(9):865-869. doi: 10.1080/17474124.2017.1355235. Epub 2017 Jul 18.
Population-based data on the development of second malignant neoplasms (SMNs) following the diagnosis of hepatocellular carcinoma (HCC) are uncommon. We evaluated this clinical vignette in HCC patients within the Surveillance, Epidemiology and End Results (SEER) database.
The SEER database (1973-2012) was queried using the SEER*Stat program to determine the clinico-pathological features of HCC patients with more than one year survival who developed SMNs. Standardized incidence ratios (SIRs) were calculated to determine the risk of each type of subsequent cancers. Relative risk was assessed to determine the impact of liver transplantation on the development of second malignant neoplasms.
On SIR analysis, the following sites have an enhanced risk of developing an SMN following the diagnosis of HCC: tongue, anal canal, liver, lung, kidney, thyroid, non-Hodgkin lymphoma (both nodal and extra-nodal disease) and acute monocytic leukemia (P < 0.05 for all sites). A significantly higher RR was found for the development of lung cancer (RR = 2.096), thyroid cancer (RR = 3.045) and non-Hodgkin lymphoma (RR = 3.822) among patients who underwent liver transplantation compared to those who did not (P < 0.05).
There is an excess risk for developing a number of SMNs among patients diagnosed with HCC.
关于肝细胞癌（HCC）诊断后发生第二原发性恶性肿瘤（SMN）的基于人群的数据并不常见。我们在监测、流行病学和最终结果（SEER）数据库中评估了HCC患者的这一临床情况。
使用SEER*Stat程序查询SEER数据库（1973 - 2012年），以确定发生SMN且生存超过一年的HCC患者的临床病理特征。计算标准化发病率（SIR）以确定每种后续癌症的风险。评估相对风险以确定肝移植对第二原发性恶性肿瘤发生的影响。
在SIR分析中，以下部位在HCC诊断后发生SMN的风险增加：舌、肛管、肝脏、肺、肾、甲状腺、非霍奇金淋巴瘤（包括淋巴结和结外疾病）以及急性单核细胞白血病（所有部位P < 0.05）。与未接受肝移植的患者相比，接受肝移植的患者发生肺癌（RR = 2.096）、甲状腺癌（RR = 3.045）和非霍奇金淋巴瘤（RR = 3.822）的RR显著更高（P < 0.05）。
在诊断为HCC的患者中，发生多种SMN存在额外风险。
