脑胶质瘤患者继发第二原发恶性肿瘤的相关分析

Correlation analysis of second primary malignancies in patients with glioma

目的分析脑胶质瘤患者继发第二原发恶性肿瘤(second primary malignancy,SPM)的发生情况及其危险因素。方法收集2000年1月至2021年12月监测、流行病学和结果(surveillance,epidemiology,and end results,SEER)数据库中诊断为脑胶质瘤患者的病例资料,回顾性分析患者的人口学特征、临床特征与SPM发生情况,采用单因素、多因素Cox风险回归分析其危险因素。结果从SEER数据库中共筛选出87889例脑胶质瘤患者,其中发生SPM患者为1043例。发生SPM患者中位总生存时间(overall survival,OS)为105.0个月。主要部位为乳腺(34.08%),肺和支气管(11.27%)以及甲状腺(10.99%)。多因素Cox回归显示,年龄(≥65岁:HR=3.047,95%CI:2.570~3.613,P<0.001)、病理(胶质母细胞瘤:HR=2.091,95%CI:1.7930~2.438,P<0.001)和放疗(HR=1.489,95%CI:1.276~1.736,P<0.001)是影响SPM发生的独立危险因素。结论乳腺、肺和支气管和甲状腺是脑胶质瘤患者SPM最常见的发生部位,年龄、病理和放疗是SPM发生的重要危险因素,这些危险因素的确定能够指导脑脑胶质瘤患者的个性化随访及SPM的筛查。

Objective To analyze the occurrence of second primary malignancies(SPM)in patients with glioma and identify their risk factors.Methods Cases of glioma patients diagnosed from January 2000 to December 2021 were collected from the Surveillance,Epidemiology,and End Results(SEER)database.A retrospective analysis was performed on patients'demographic characteristics,clinical features,and SPM occurrence,using univariate and multivariate Cox regression analysis to identify risk factors.Results A total of 87,889 glioma patients were screened from the SEER database,with 1,043 developing SPM.The median overall survival(OS)for patients with SPM was 105.0 months.The most common sites for SPMs were the breast(34.08%),lung and bronchi(11.27%),and thyroid(10.99%).Multivariate Cox regression analysis showed that age(≥65 years:HR=3.047,95%CI:2.570~3.613,P<0.001),pathology(glioblastoma:HR=2.091,95%CI:1.793~2.438,P<0.001),and radiotherapy(HR=1.489,95%CI:1.276~1.736,P<0.001)were independent risk factors for the occurrence of SPM.Conclusion Breast,lung and bronchi,and thyroid are the most common sites of SPM in glioma patients.Age,pathology,and radiotherapy are significant risk factors for SPM occurrence.Identifying these risk factors can guide personalized follow-up and screening for SPM in glioma patients.