Nakamizo M, Kamata S, Kawabata K, Takahashi H, Nigauri T, Hoki K, Uchida M, Hiyama T
Division of Head and Neck, Cancer Institute Hospital, Tokyo.
Nihon Jibiinkoka Gakkai Kaiho. 1993 Sep;96(9):1501-9. doi: 10.3950/jibiinkoka.96.1501.
In a total of 2083 cases of hollow organ cancer of the head and neck region treated in our institute in the past 20 years, the relative risk of second primary cancers was statistically studied by the person-year approach. The organ association in multiple primary cancers and the relationship between tobacco and alcohol consumption and the development of second primary cancers were also reviewed. The incidence of second primary cancers was significantly (p < 0.05) higher in patients having a lesion at the tongue (n = 502), mesopharynx (n = 188), hypopharynx (n = 224) and larynx (n = 621) and in the oral cavity (n = 203) than in the general population. With regard to organ association in multiple primary cancers, cancers in the oral cavity, esophagus and at the pharynx were found to occur as second primary cancers of the tongue, oral cavity, meso-hypopharynx and larynx at significantly high rates in males. Male laryngeal cancer was related to the lung. No relation of female lingual cancer to the esophagus was noted. The incidence of second primary cancer was very high in persons who had been heavy smokers and/or heavy drinkers before the occurrence of their primary cancer in the head and neck region. In these people, second primary cancers were found to occur at high rates as cancers related to tobacco smoking and drinking. Otherwise, in cases with head and neck cancers less related to tobacco smoking and drinking, the incidence of second primary cancers was low. From the above results, tobacco smoking and drinking may be closely related to a high incidence of second primary cancer following the first primary cancer in the head and neck region.
在过去20年里，我院共治疗了2083例头颈部中空器官癌症患者，采用人年法对第二原发性癌症的相对风险进行了统计学研究。还回顾了多原发性癌症中的器官关联以及烟草和酒精消费与第二原发性癌症发生之间的关系。舌部（n = 502）、中咽部（n = 188）、下咽（n = 224）、喉部（n = 621）及口腔（n = 203）有病变的患者，其第二原发性癌症的发生率显著高于普通人群（p < 0.05）。关于多原发性癌症中的器官关联，发现口腔、食管和咽部的癌症作为舌部、口腔、中下咽和喉部的第二原发性癌症在男性中发生率显著较高。男性喉癌与肺癌有关。未发现女性舌癌与食管癌有关。在头颈部原发性癌症发生前曾大量吸烟和/或大量饮酒的人群中，第二原发性癌症的发生率非常高。在这些人群中，发现第二原发性癌症以与吸烟和饮酒相关的癌症的高发生率出现。否则，在与吸烟和饮酒关系较小的头颈部癌症病例中，第二原发性癌症的发生率较低。从上述结果来看，吸烟和饮酒可能与头颈部第一原发性癌症后第二原发性癌症的高发生率密切相关。
