Huang Xiaoyi, Zhang Bingbing, Zhao Jian, Sun Chen, Kong Kaiwen, Deng Lulu, Liu Yanfang, Zheng Jianming
Department of Pathology, Changhai Hospital, Second Military Medical University, Shanghai, China.
Department of Orthopaedics, Changhai Hospital, Second Military Medical University, Shanghai, China.
Front Oncol. 2019 Jul 9;9:610. doi: 10.3389/fonc.2019.00610. eCollection 2019.
Several studies have reported that intraductal papillary mucinous neoplasms (IPMNs) of the pancreas are associated with extra-pancreatic malignancies. However, there have been no population-based studies evaluating the risk of second primary cancers (SPCs) in patients with pancreatic IPMN. The Surveillance, Epidemiology, and End Results (SEER) database was used to identify and characterize data from patients with IPMN of the pancreas. The standard incidence ratio (SIR) of this cancer was calculated by estimating the relative risk (RR). A multivariate Cox regression model was used to estimate hazards ratios (HRs) of death and associated 95% CIs. Of 2,850 patients with IPMN of the pancreas, 104 patients (3.65%) developed 118 SPCs. The SIR for all SPCs combined was 1.22 (95% confidence interval [CI] = 1.01-1.46; < 0.05). There was an elevated risk of site-specific SPCs in the small intestine (SIR = 8.68; 95% CI = 2.36-22.22), pancreas (SIR = 2.66; 95% CI = 1.15-5.25), urinary bladder (SIR = 2.02; 95% CI = 1.05-3.54), and eye and orbit (SIR = 13.47; 95% CI = 1.63-48.67) in patients with pancreas IPMN. In age subgrouping, people aged younger than 50 years had an increased risk of all-site SPC with an SIR of 6.44 (95% CI = 2.78-12.68). Cox regression modeling showed that advanced disease stage and a short latency period carried a higher risk of death in IPMN patients with SPC. Patients diagnosed with pancreatic IPMNs were at higher risk than the general population for developing a second primary malignancy. Meanwhile, advanced historic stage and short latency period were associated with an elevated HR in IPMN patients who develop an SPC.
多项研究报告称，胰腺导管内乳头状黏液性肿瘤（IPMN）与胰腺外恶性肿瘤有关。然而，尚无基于人群的研究评估胰腺IPMN患者发生第二原发性癌症（SPC）的风险。利用监测、流行病学和最终结果（SEER）数据库来识别和描述胰腺IPMN患者的数据。通过估计相对风险（RR）来计算该癌症的标准发病率比（SIR）。使用多变量Cox回归模型来估计死亡风险比（HR）及相关的95%置信区间（CI）。在2850例胰腺IPMN患者中，104例（3.65%）发生了118例SPC。所有SPC合并后的SIR为1.22（95%置信区间[CI]=1.01 - 1.46；P<0.05）。胰腺IPMN患者在小肠（SIR = 8.68；95% CI = 2.36 - 22.22）、胰腺（SIR = 2.66；95% CI = 1.15 - 5.25）、膀胱（SIR = 2.02；95% CI = 1.05 - 3.54）以及眼和眼眶（SIR = 13.47；95% CI = 1.63 - 48.67）发生特定部位SPC的风险升高。在年龄亚组分析中，年龄小于50岁的人群发生所有部位SPC的风险增加，SIR为6.44（95% CI = 2.78 - 12.68）。Cox回归模型显示，疾病晚期和潜伏期短在发生SPC的IPMN患者中死亡风险更高。诊断为胰腺IPMN的患者发生第二原发性恶性肿瘤的风险高于一般人群。同时，在发生SPC的IPMN患者中，疾病晚期和潜伏期短与较高的HR相关。
