Osterlind A, Olsen J H, Lynge E, Ewertz M
Natl Cancer Inst Monogr. 1985 Dec;68:361-88.
Second primary cancers were studied in persons with rare tumors between 1943 and 1980. The risk of developing a new cancer was evaluated in 7,211 persons with cutaneous melanoma, 1,784 persons with eye cancer, 10,273 persons with tumors of the brain and nervous system, 1,935 persons with thyroid cancer, 1,542 persons with bone tumors, and 2,318 persons with malignant neoplasms of the connective tissue. All cancer patients were diagnosed in Denmark between 1943 and 1980 and survived for 2 or more months. Nonmelanoma skin cancers were excluded from the analysis, whereas tumors of the brain and nervous system included both benign and malignant neoplasms. Overall, patients with these cancers showed no greater incidence of new tumors than expected from comparisons with the general population. An excess of chronic lymphocytic leukemia was observed subsequent to all cancers derived from the neural tube, i.e., melanoma and tumors of the eye, brain, and nervous system. Bone cancer occurred excessively, although the possibility of misclassified metastases could not be eliminated. Patients with tumors of the brain and nervous system who survived for 10 or more years developed significantly more cancers of the kidney and connective tissue and melanoma than anticipated. A deficit of second cancers of the digestive system was noted after primary bone and connective tissue cancers, in contrast to an excess of second cancers of the lung and kidney. Although based on few cases, patients with bone cancer showed a large excess of eye cancer as a second primary. The association between cancers of the breast and connective tissue was found to be bidirectional. Persons with connective tissue cancer were at increased risk of developing non-Hodgkin's lymphoma. Thyroid cancer patients were at high risk of subsequent tumors of the brain and nervous tissue and non-Hodgkin's lymphoma. However, contrary to previous reports, the risk of breast cancer was not elevated following thyroid cancer.
1943年至1980年间，对患有罕见肿瘤的人群中的第二原发性癌症进行了研究。评估了7211例皮肤黑色素瘤患者、1784例眼癌患者、10273例脑和神经系统肿瘤患者、1935例甲状腺癌患者、1542例骨肿瘤患者以及2318例结缔组织恶性肿瘤患者患新发癌症的风险。所有癌症患者均于1943年至1980年间在丹麦被诊断出，且存活了2个月或更长时间。分析中排除了非黑色素瘤皮肤癌，而脑和神经系统肿瘤包括良性和恶性肿瘤。总体而言，与普通人群相比，这些癌症患者并未表现出更高的新发肿瘤发生率。在所有源自神经管的癌症（即黑色素瘤以及眼、脑和神经系统肿瘤）之后，观察到慢性淋巴细胞白血病的发生率过高。骨癌的发生也过多，尽管不能排除转移分类错误的可能性。存活10年或更长时间的脑和神经系统肿瘤患者发生肾癌、结缔组织癌和黑色素瘤的比例明显高于预期。与原发性骨癌和结缔组织癌后消化系统第二原发性癌症的不足相反，肺癌和肾癌的第二原发性癌症过多。尽管病例数较少，但骨癌患者的眼癌作为第二原发性癌症的发生率大幅过高。发现乳腺癌与结缔组织癌之间的关联是双向的。结缔组织癌患者患非霍奇金淋巴瘤的风险增加。甲状腺癌患者患随后的脑和神经组织肿瘤以及非霍奇金淋巴瘤的风险较高。然而，与先前的报告相反，甲状腺癌后乳腺癌的风险并未升高。
