Tihan T, Filippa D A
Department of Pathology, Memorial Sloan-kettering Cancer Center, New York, New York 10021, USA.
Cancer. 1996 Jun 1;77(11):2325-31. doi: 10.1002/(SICI)1097-0142(19960601)77:11<2325::AID-CNCR22>3.0.CO;2-Y.
Secondary malignant neoplasms are increasingly being observed in cancer populations and a considerable amount of data have accumulated in the literature. Among the secondary malignant neoplasms that occur with a higher incidence in cancer patients are lymphomas and renal cell carcinoma (RCC), as well as melanoma, lung/bronchus carcinoma.
The authors analyzed the patient population at the Memorial Sloan-Kettering Cancer Center in New York City between 1985 and 1995 for coexisting carcinomas, and identified 15 patients who had both RCC and malignant lymphoma among a total of 1262 patients with RCC and 1660 patients with malignant lymphoma. The occurrence and time of diagnosis of both malignant neoplasms and their clinical features, types, and stages, as well as short term follow-up, results, are presented.
The data show a greater than coincidental coexistence of RCC and malignant lymphoma (P < 0.01). In addition, there was a significant increase in the number of patients with both melanoma and RCC (P < 0.01), as well as melanoma and malignant lymphoma (P < 0.01). No significant increase was found in cases of coexisting RCC or malignant lymphoma with either lung/bronchus carcinoma or colorectal carcinoma (P > 0.05).
Causes of this increased coexistence may include a genetic predisposition to cancer, similar immune mechanisms associated with these neoplasms, closer scrutiny of this group of patients, or a combination of these factors. Studies are underway to elucidate a common genetic component in these patients.
继发性恶性肿瘤在癌症患者群体中越来越多地被观察到，并且文献中已经积累了大量数据。在癌症患者中发病率较高的继发性恶性肿瘤包括淋巴瘤和肾细胞癌（RCC），以及黑色素瘤、肺/支气管癌。
作者分析了1985年至1995年纽约市纪念斯隆凯特琳癌症中心的患者群体中并存的癌症情况，在总共1262例肾细胞癌患者和1660例恶性淋巴瘤患者中，确定了15例同时患有肾细胞癌和恶性淋巴瘤的患者。呈现了两种恶性肿瘤的发生、诊断时间及其临床特征、类型和分期，以及短期随访结果。
数据显示肾细胞癌和恶性淋巴瘤的并存情况并非偶然（P < 0.01）。此外，同时患有黑色素瘤和肾细胞癌的患者数量显著增加（P < 0.01），以及黑色素瘤和恶性淋巴瘤的患者数量也显著增加（P < 0.01）。在肾细胞癌或恶性淋巴瘤与肺/支气管癌或结直肠癌并存的病例中未发现显著增加（P > 0.05）。
这种并存情况增加的原因可能包括对癌症的遗传易感性、与这些肿瘤相关的相似免疫机制、对这组患者的更密切检查，或这些因素的综合作用。目前正在进行研究以阐明这些患者中共同的遗传成分。
