生物谷报道：美国芝加哥大学医学中心研究人员在《内科学文献》（Arch Intern Med）发表论文表示相对于一般人群，输尿管癌和肾盂癌患者继发结直肠癌(CRC)危险分别增加80%和44%，同样，CRC患者继发泌尿系统肿瘤危险也增加，继发肾盂癌危险增加59%，继发输尿管癌危险增加100%。
研究人员对美国监测、流行病学与最终结果数据库(SEER)中186972例泌尿系统肿瘤患者和357597例CRC患者的资料进行了回顾性分析。
结果显示，泌尿系肿瘤患者中2789例继发CRC，总发病率为272.2例/10万人/年（标准化发病比SIR=1.13），其中输尿管癌和肾盂癌患者SIR分别为1.80和1.44。若诊断时年龄较小，继发CRC危险更高，肾盂癌诊断时<50岁，该危险增至5倍，输尿管癌诊断时<60岁，该危险加倍。
CRC患者中3026例继发泌尿系统肿瘤，总发病率为168.9例/10万人/年(SIR=1.24)，继发肾盂癌和输尿管癌的SIR分别为1.59和2.00，CRC至泌尿系统肿瘤诊断中位间隔时间为3.8年。多发性CRC患者继发危险较单发者更高，继发肾盂癌和输尿管癌的SIR分别为3.2和5.3。诊断CRC时年龄<50岁者继发泌尿系肿瘤危险加倍。
研究人员认为，肾盂癌和输尿管癌患者尤其较年轻患者，继发CRC危险增加，CRC患者尤其较年轻或多发性癌患者，发生肾盂癌和输尿管癌危险增加，这可能与两个系统肿瘤有共同的病理遗传学机制有关，并可能对筛查有指导意义。（生物谷www.bioon.com）
生物谷推荐原始出处：
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.
