PO.CL11.01 · 临床研究
肺腺癌与尿路上皮癌：长庚医疗财团法人双重癌症分析
Lung adenocarcinoma and urothelial carcinoma: Analysis of double cancer in Chang-Gung Medical Foundation
作者与单位 Authors & Affiliations
摘要 Abstract
中文摘要
背景：马兜铃酸（AA）形成致癌性DNA加合物，可在人尿路（肾脏、输尿管和膀胱）、肝脏及胰腺、乳腺和肺等非靶组织中检测到。AA被认为是尿路上皮癌（UC）的病因，但其在肺癌中的致癌作用仍存争议。本研究计划探讨尿路上皮癌与肺腺癌（LA）双重癌症的特征。方法：我们在台湾开展了这项多机构队列研究。从长庚研究数据库（CGRD）中检索了两个独立队列。第一个队列（UCLA）纳入1994年至2023年间患有尿路上皮癌（UC）与肺腺癌（LA）双重癌症的患者，第二个队列（CGMH-EGFRm）纳入2011年至2020年间EGFR突变型LA患者。UCLA进一步按癌症发生顺序分组（第1组：UC的索引诊断日期早于LA；第2组：LA与UC同时发生；第3组：LA早于UC），CGMH-EGFRm分为活化型EGFR突变（第4组）和其他突变（第5组）。末次随访时间为2023年12月30日。描述性统计采用卡方检验和Fisher精确检验。P<0.05设为具有统计学意义。结果：1994年至2023年间，队列1由196例患者组成，其中第1组126例、第2组30例、第3组40例；2011年至2020年间，队列2由3,427例患者组成。末次随访时间为2023年12月30日，第1、2、3组的平均年龄分别为73、73和67岁。第1、2、3组男性占比分别为65.9%、66.7%和67.5%，吸烟习惯分别为30.2%、26.7%和42.5%。年龄、性别、吸烟习惯等基线特征在第1至5组之间存在差异，而在UCLA队列内，性别和吸烟习惯相似。双重癌症之间的诊断中位间隔分别为2381.5天（范围：131至10556）、8.5天（0至84）和755.5天（98至4390）。2000年代之后（基于UC诊断年份），第2组和第3组呈增加趋势。LA的解剖位置在第1至3组之间相似（p=0.660），第3组肾盂和输尿管UC呈增加趋势（p=0.104）。结论：在CGRD中，1.1%的UC可发展为LA。有必要进行组间进一步的基因组分析，以阐明AA在双重癌症中的致癌作用。
查看英文原文 English abstract
Background: Aristolochic acids (AA) form carcinogenic DNA adducts, which can be detected in human urinary tract (kidney, ureter, and urinary bladder), liver, and non-target tissues such as pancreas, breast, and lung. AA is blamed for urothelial carcinoma (UC) but its carcinogenic role on lung cancer is still under debate. This study plans to investigate the characteristics of double cancers with urothelial carcinoma and lung adenocarcinoma (LA). Methods: We conducted this multi-institutional cohort study in Taiwan. Two independent cohorts were retrieved from Chang-Gung Research Database (CGRD). The first cohort (UCLA) included patients with double cancers with urothelial carcinoma (UC) and lung adenocarcinoma (LA) from 1994 to 2023 and the second cohort (CGMH-EGFRm) with EGFR-mutated LA from 2011 to 2020. UCLA was further divided into groups according to the sequence of cancer development (group 1: index diagnosis date of UC before LA; group 2: simultaneous LA and UC; group 3:LA before UC), and CGMH-EGFRm was divided into activating EGFR-mutations (group 4) and other mutations (group 5). The last follow-up time was Dec 30, 2023. Descriptive statistics are provided with Chi-Squared and Fisher's Exact Test. P<0.05 was set to be statistic significance.Results: From 1994 to 2023, cohort 1 comprised of 196 patients of which 126 in group 1, 30 in group 2, and 40 in group 3 and from 2011 to 2020 cohort 2 comprised of 3,427 patients. The last follow-up time was Dec 30, 2023, and the mean age of group 1, 2, and 3 was 73, 73, and 67, respectively. The male gender in group 1, 2, and 3 was 65.9%, 66.7%, and 67.5%, and smoking habit was 30.2%, 26.7%, and 42.5%, respectively. The baseline characteristics such as age, gender, smoking habits were different from group 1 to 5, while in UCLA cohort, gender and smoking habits were similar. The median interval of diagnosis between double cancer was 2381.5 (range: 131 to 10556), 8.5 (0 to 84) and 755.5 (98 to 4390) days, respectively. After 2000s (based on year of diagnosis with UC), there was an increasing trend in group 2 and 3. The anatomical locations of LA was similar between groups 1 to 3 (p=0.660), and a trend of increasing renal pelvis and ureter UC in group 3 (p=0.104). Conclusion: 1.1% of UC can develop LA in CGRD. Further genomic analysis between groups was warranted to elucidate the carcinogenic role of AA in double cancers.
利益披露 Disclosure
F. Kuan, None.