Miki Yasuhiro, Sugawara Yumi, Shibahara Yukiko, Tsuji Ichiro, Sasano Hironobu, Ito Kiyoshi
Department of Disaster Obstetrics and Gynecology, International Research Institute of Disaster Science (IRIDeS), Tohoku University, Sendai, Japan.
Department of Public Health, Tohoku University Graduate School of Medicine, Sendai, Japan.
J Obstet Gynaecol Res. 2019 May;45(5):1012-1018. doi: 10.1111/jog.13934. Epub 2019 Feb 7.
A thorough analysis of multiple primary cancers (MPC) could provide important information as to the pathogenesis of human malignancies. Analysis of MPC using clinical databases has been performed, but little has been done using autopsy cases. Therefore, in this study, we first retrospectively analyzed MPC associated with endometrial and ovarian cancers using the Japan Autopsy Annual Database.
The Japan Autopsy Annual Database from 2002 to 2010 was established by the Japanese Society of Pathology, Tokyo, Japan. Among the 164 211 autopsy cases registered, 9142 were cases of primary cancers.
The patients with endometrial cancer-associated MPC did have a lower risk of harboring colorectal cancer (odds ratio [OR], 0.63; 95% confidence interval [CI], 0.45-0.89) but had a higher risk of ovarian cancer (OR, 3.15; 95% CI, 2.11-4.71). Those with ovarian cancer-associated MPC had a lower risk of harboring gallbladder cancer including bile ductal cancer (OR, 0.47; 95% CI, 0.27-0.80) but a higher risk of harboring breast (OR, 1.69; 95% CI, 1.20-2.38) and endometrial cancers (OR, 3.48; 95% CI, 2.33-5.20).
Both endogenous and exogenous factors are associated with the incidence of MPC. Results of our present study based on Japanese Autopsy Base first demonstrated that female hormones had a strong influence on the incidence of MPC. This study also demonstrated that the analysis of MPC using an autopsy database could have advantages over clinical database analysis.
对多原发性癌(MPC)进行全面分析可为人类恶性肿瘤的发病机制提供重要信息。利用临床数据库对MPC进行分析已有相关研究,但利用尸检病例进行的研究较少。因此,在本研究中,我们首先使用日本尸检年度数据库对与子宫内膜癌和卵巢癌相关的MPC进行回顾性分析。
日本病理学会于2002年至2010年建立了日本尸检年度数据库。在登记的164211例尸检病例中,9142例为原发性癌病例。
子宫内膜癌相关MPC患者患结直肠癌的风险较低(优势比[OR],0.63;95%置信区间[CI],0.45 - 0.89),但患卵巢癌的风险较高(OR,3.15;95%CI,2.11 - 4.71)。卵巢癌相关MPC患者患胆囊癌(包括胆管癌)的风险较低(OR,0.47;95%CI,0.27 - 0.80),但患乳腺癌(OR,1.69;95%CI,1.20 - 2.38)和子宫内膜癌的风险较高(OR,3.48;95%CI,2.33 - 5.20)。
内源性和外源性因素均与MPC的发病率相关。我们基于日本尸检数据库的本研究结果首次表明,女性激素对MPC的发病率有强烈影响。本研究还表明,利用尸检数据库分析MPC可能比临床数据库分析更具优势。