生物谷報道：美國芝加哥大學(xué)醫(yī)學(xué)中心研究人員在《內(nèi)科學(xué)文獻》（Arch Intern Med）發(fā)表論文表示相對于一般人群,，輸尿管癌和腎盂癌患者繼發(fā)結(jié)直腸癌(CRC)危險分別增加80%和44%，同樣,，CRC患者繼發(fā)泌尿系統(tǒng)腫瘤危險也增加,，繼發(fā)腎盂癌危險增加59%,，繼發(fā)輸尿管癌危險增加100%。
研究人員對美國監(jiān)測,、流行病學(xué)與最終結(jié)果數(shù)據(jù)庫(SEER)中186972例泌尿系統(tǒng)腫瘤患者和357597例CRC患者的資料進行了回顧性分析,。
結(jié)果顯示，泌尿系腫瘤患者中2789例繼發(fā)CRC,，總發(fā)病率為272.2例/10萬人/年（標(biāo)準(zhǔn)化發(fā)病比SIR=1.13）,，其中輸尿管癌和腎盂癌患者SIR分別為1.80和1.44,。若診斷時年齡較小，繼發(fā)CRC危險更高,，腎盂癌診斷時<50歲,，該危險增至5倍，輸尿管癌診斷時<60歲,，該危險加倍,。
CRC患者中3026例繼發(fā)泌尿系統(tǒng)腫瘤，總發(fā)病率為168.9例/10萬人/年(SIR=1.24),，繼發(fā)腎盂癌和輸尿管癌的SIR分別為1.59和2.00,，CRC至泌尿系統(tǒng)腫瘤診斷中位間隔時間為3.8年。多發(fā)性CRC患者繼發(fā)危險較單發(fā)者更高,，繼發(fā)腎盂癌和輸尿管癌的SIR分別為3.2和5.3。診斷CRC時年齡<50歲者繼發(fā)泌尿系腫瘤危險加倍,。
研究人員認(rèn)為,，腎盂癌和輸尿管癌患者尤其較年輕患者，繼發(fā)CRC危險增加,，CRC患者尤其較年輕或多發(fā)性癌患者,，發(fā)生腎盂癌和輸尿管癌危險增加，這可能與兩個系統(tǒng)腫瘤有共同的病理遺傳學(xué)機制有關(guān),，并可能對篩查有指導(dǎo)意義,。（生物谷www.bioon.com）
生物谷推薦原始出處：
Arch Intern Med，168(9):1003-1009,，Audrey H. Calderwood,，David T. Rubin
Association Between Colorectal Cancer and Urologic Cancers
Audrey H. Calderwood, MD; Dezheng Huo, PhD; David T. Rubin, MD
Arch Intern Med. 2008;168(9):1003-1009.
Background Different types of urologic cancers have been associated with colorectal cancer (CRC) in hereditary nonpolyposis CRC, but it is still unknown whether there is an association between urologic cancer and CRC in the general population. We sought to quantify the risk for CRC after urologic cancer and the risk for urologic cancer after CRC in patients without known genetic syndromes.
Methods We performed a retrospective cohort analysis of the Surveillance, Epidemiology, and End Results program database from 1973 to 2000. Standard incidence ratios (SIRs) of observed to expected cases of invasive CRC were calculated for each urologic cancer site based on age, sex, ethnicity, and calendar year of diagnosis. Similar analysis was performed to determine the SIRs of urologic cancers in patients with previous CRC.
Results Overall, the risk for CRC was increased among patients with previous ureteral cancer (SIR, 1.80; 95% confidence interval [CI], 1.46-2.20) and renal pelvis cancer (SIR, 1.44; 95% CI, 1.20-1.72). This risk was greatest among patients who received the diagnosis of renal pelvis or ureteral cancer before the age of 60 years. There was a minimal increased risk for subsequent CRC in patients with bladder or renal parenchymal cancer. Overall, the risk for urologic cancer was increased after a diagnosis of CRC (SIR, 1.24; 95% CI, 1.20-1.28), with the highest risk for subsequent renal pelvis and ureteral cancers in patients with a CRC diagnosis before the ages of 50 to 60 years or multiple primary CRCs.
Conclusions Previous renal pelvis and ureteral cancers, particularly when diagnosed at an early age, increase the risk for subsequent CRC. Likewise, a history of CRC, especially in cases with multiple primary tumors, is associated with an increased risk of renal pelvis and ureteral cancers. These findings support a possible common pathogenetic mechanism between CRC and urologic cancers and may have implications for screening guidelines.
Author Affiliations: Department of Medicine, Section of Gastroenterology, The University of Chicago Medical Center (Drs Calderwood and Rubin), and Department of Health Studies, The University of Chicago (Dr Huo), Chicago, Illinois.
