结直肠癌患者第二原发恶性肿瘤流行病学特征分析  

Epidemiological characteristics of the second primary malignancies in colorectal cancer patients

作　　者：郭星灵 袁晶[2] 徐海峰[3] 武振宇[1] GUO Xingling;YUAN Jing;XU Haifeng;WU Zhenyu(School of Public Health,Fudan University,Shanghai 200032,China;不详)

机构地区：[1]复旦大学公共卫生学院,上海200032 [2]复旦大学附属肿瘤医院 [3]上海市奉贤区疾病预防控制中心慢性病防治科,上海201400

出　　处：《中国慢性病预防与控制》2024年第7期499-503,共5页Chinese Journal of Prevention and Control of Chronic Diseases

基　　金：上海市卫生健康委科研项目(202140018);国家自然科学基金(82173613,82373681)。

摘　　要：目的了解中国结直肠癌患者第二原发恶性肿瘤的特征及分布情况,为结直肠癌患者的后续随访、监测和健康管理提供依据。方法收集1996—2015年在复旦大学附属肿瘤医院进行诊治的所有结直肠癌患者数据,分析比较不同年龄、性别、部位结直肠癌患者的第二原发恶性肿瘤的流行病学特征。采用R 4.2.2进行统计学分析。结果共纳入7890例结直肠癌患者,其中226例(2.86%)患者患有第二原发恶性肿瘤,且接受化疗(3.40%)和第一原发部位为结肠癌(3.33%)的患者第二原发恶性肿瘤发病比例更高。肺是最常见的第二原发恶性肿瘤部位(20.35%),其他易感部位依次为结肠、乳腺、胃、前列腺、直肠、甲状腺和肾等。第二原发恶性肿瘤与结直肠癌的中位间隔时间为3.25年,肺、甲状腺、结肠、前列腺、乳腺和肾的第二原发恶性肿瘤与结直肠癌的中位间隔时间为2~4年,直肠和胃的第二原发恶性肿瘤与结直肠癌的中位间隔时间为5.5~6年。结论第二原发恶性肿瘤在接受化疗和第一原发部位为结肠癌的患者中发生比例更高,且主要发生在肺、消化系统和泌尿生殖系统。各部位的中位间隔时间约为初始结直肠癌诊断后的2~6年,需在此期间内对第二原发恶性肿瘤易感部位进行密切监测。Objective To understand the epidemiological characteristics and distribution of the second primary malignancies(SPMs)in colorectal cancer patients of China,and provide the basis for subsequent follow-up,monitoring,and health management of colorectal cancer patients.Methods Data of all colorectal cancer patients treated at the Affiliated Cancer Hospital of Fudan University from 1996 to 2015 were collected.The epidemiological characteristics of SPMs in colorectal cancer patients with different age,sex and location were analyzed and compared.Statistical analysis was performed using R 4.2.2.Results A total of 7890 colorectal cancer patients were included,of whom 226 cases(2.86%)had SPMs,with a higher incidence of SPMs among patients undergoing chemotherapy(3.40%)and with colon cancer(3.33%).The lung is the most common site of SPMs(20.35%),and the other susceptible sites are the colon,breast,stomach,prostate,rectum,thyroid,kidney and so on.The median interval between SPMs and colorectal cancer was 3.25 years,the median interval between colorectal cancer and SPMs of lung,thyroid,colon,prostate,breast and kidney was 2 to 4 years,and the median interval between colorectal cancer and SPMs of rectum and stomach was 5.5 to 6 years.Conclusion The incidence of SPMs was higher among colon cancer patients and those who received chemotherapy,which mainly occur in lungs,the digestive system and the genitourinary system.The median interval at each site was approximately 2 to 6 years after the initial colorectal cancer diagnosis,the vulnerable site to SPMs should be closely monitored during the period.

关 键 词：结直肠癌 第二原发恶性肿瘤 流行病学特征 健康管理 

分 类 号：R735.34[医药卫生—肿瘤]