Mitchell C
Department of Haematology and Oncology, Institute of Child Health, London, UK.
Ophthalmic Paediatr Genet. 1988 Nov;9(3):161-5. doi: 10.3109/13816818809031493.
Second malignant neoplasms (SMN) are distinct from primary neoplasms in site, time and histology. SMN may arise by chance or due to the influences of chemotherapeutic agents, therapeutic irradiation or genetic predisposition. Patients with the hereditary form of retinoblastoma (RB) appear genetically predisposed to the development of connective tissue tumours, particularly osteosarcoma. Therapeutic irradiation is an additional risk. Quantitation of the risk of SMN in RB patients may be influenced by selection biases and inappropriate analyses. Much of the biases in reported series arises from the limitations of single-centre studies. Loss of patients to follow-up, failure to adhere to properly defined criteria of SMN and to consider the risk of malignancy in the general population may have led to over-estimation of the risk of SMN in retinoblastoma patients.
第二原发性恶性肿瘤（SMN）在部位、时间和组织学上与原发性肿瘤不同。SMN可能偶然发生，也可能是由于化疗药物、治疗性放疗或遗传易感性的影响。遗传性视网膜母细胞瘤（RB）患者似乎在遗传上易患结缔组织肿瘤，尤其是骨肉瘤。治疗性放疗是另一个风险因素。RB患者中SMN风险的定量可能受到选择偏倚和不适当分析的影响。报告系列中的许多偏倚源于单中心研究的局限性。患者失访、未遵循适当定义的SMN标准以及未考虑一般人群中的恶性肿瘤风险，可能导致对视网膜母细胞瘤患者中SMN风险的高估。
