黑色素瘤亚型患者的第二原发性恶性肿瘤：对监测、流行病学和最终结果（SEER）数据库中120299例患者的分析（2000 - 2016年）
Second Primary Malignancies in Patients With Melanoma Subtypes: Analysis of 120,299 Patients From the SEER Database (2000-2016).
作者信息
Loya Asad, Gombos Dan S, Patel Sapna P
机构信息
School of Medicine, Baylor College of Medicine, Houston, TX, United States.
Section of Ophthalmology, Department of Head and Neck Surgery, The University of Texas MD Anderson Cancer Center, Houston, TX, United States.
出版信息
Front Oncol. 2022 Mar 18;12:853076. doi: 10.3389/fonc.2022.853076. eCollection 2022.
PURPOSE
Evaluate incidence of second primary malignancies (SPM) after non-acral cutaneous melanoma (NACM), acral lentiginous melanoma (ALM), mucosal melanoma (MM), and uveal melanoma (UM).
PATIENTS AND METHODS
First primary NACM, ALM, MM, and UM cases diagnosed 2000-2016 were extracted from SEER. Seer*Stat was used to calculate excess absolute risks (EAR) and standardized incidence ratios (SIR) of SPMs relative to a matched cohort from the general population. P-value of 0.05 determined significance.
RESULTS
Inclusion criteria was met by 109,385 patients with NACM, 2166 with ALM, 2498 with MM, and 6250 with UM. Increased incidence of malignancies occurred after NACM (SIR 1.51; 95%CI, 1.49-1.54), ALM (SIR 1.59; 95%CI, 1.40-1.81), MM (SIR 2.14; 95%CI, 1.85-2.45), and UM (SIR 1.24; 95%CI, 1.14-1.34) relative to the general population. Cutaneous melanoma occurred more frequently after NACM (SIR 9.54; 95%CI, 9.27-9.83), ALM (SIR 12.19; 95%CI, 9.70-15.14), MM (SIR 10.05; 95%CI, 7.18-13.68), and UM (SIR 2.91; 95%CI, 2.27-3.66). Patients with initial NACM (SIR 2.44; 95%CI, 1.64-3.51) and UM (SIR 44.34; 95%CI, 29.91-63.29) demonstrated increased incidence of eye and orbit melanoma. Renal malignancies occurred more frequently after NACM (SIR 1.24; 95%CI, 1.11-1.38), MM (SIR 3.54; 95%CI, 1.62-6.72) and UM (SIR 1.68; 95%CI, 1.09-2.48). Increased incidence of thyroid malignancies was observed after NACM (SIR 1.83; 95%CI, 1.61-2.06), ALM (SIR 3.74; 95%CI, 1.71-7.11), MM (SIR 4.40; 95%CI, 1.77-9.06), and UM (SIR 3.79; 95%CI, 2.52-5.47). Increased incidence of lymphoma was observed after NACM (SIR 1.20; 95%CI, 1.09-1.31) and ALM (SIR 2.06; 95%CI, 1.13-3.46).
CONCLUSION
Patients with NACM, ALM, MM, and UM have increased incidence of SPMs compared to that expected from the general population. Each of these melanoma subtypes had increased occurrence of cutaneous melanoma and thyroid cancer; some, but not all, had increased occurrence of renal malignancies, eye and orbit melanoma, and lymphoma.
目的
评估非肢端皮肤黑色素瘤（NACM）、肢端雀斑样痣黑色素瘤（ALM）、黏膜黑色素瘤（MM）和葡萄膜黑色素瘤（UM）后第二原发性恶性肿瘤（SPM）的发生率。
患者与方法
从监测、流行病学与最终结果（SEER）数据库中提取2000 - 2016年诊断的首例原发性NACM、ALM、MM和UM病例。使用Seer*Stat计算相对于来自普通人群的匹配队列的SPM的超额绝对风险（EAR）和标准化发病率（SIR）。P值为0.05确定为有统计学意义。
结果
109385例NACM患者、2166例ALM患者、2498例MM患者和6250例UM患者符合纳入标准。相对于普通人群，NACM（SIR 1.51；95%CI，1.49 - 1.54）、ALM（SIR 1.59；95%CI，1.40 - 1.81）、MM（SIR 2.14；95%CI，1.85 - 2.45）和UM（SIR 1.24；95%CI，1.14 - 1.34）后恶性肿瘤发生率增加。NACM（SIR 9.54；95%CI，9.27 - 9.83）、ALM（SIR 12.19；95%CI，9.70 - 15.14）、MM（SIR 10.05；95%CI，7.18 - 13.68）和UM（SIR 2.91；95%CI，2.27 - 3.66）后皮肤黑色素瘤更频繁发生。初始NACM（SIR 2.44；95%CI，1.64 - 3.51）和UM（SIR 44.34；95%CI，29.91 - 63.29）患者眼和眼眶黑色素瘤发生率增加。NACM（SIR 1.24；95%CI，1.11 - 1.38）、MM（SIR 3.54；95%CI，1.62 - 6.72）和UM（SIR 1.68；95%CI,；1.09 - 2.48）后肾恶性肿瘤更频繁发生。NACM（SIR 1.83；95%CI，1.61 - 2.06）、ALM（SIR 3.74；95%CI，1.71 - 7.11）、MM（SIR 4.40；95%CI，1.77 - 9.06）和UM（SIR 3.79；95%CI，2.52 - 5.47）后甲状腺恶性肿瘤发生率增加。NACM（SIR 1.20；95%CI，1.09 - 1.31）和ALM（SIR 2.06；95%CI，1.13 - 3.46）后淋巴瘤发生率增加。
结论
与普通人群预期相比，NACM、ALM、MM和UM患者的SPM发生率增加。这些黑色素瘤亚型中的每一种皮肤黑色素瘤和甲状腺癌的发生率都增加；一些（但不是全部）肾恶性肿瘤、眼和眼眶黑色素瘤以及淋巴瘤的发生率增加。
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