肾移植术后并发恶性肿瘤7例临床分析

Clinical analysis of malignant tumor after renal transplantation

目的：总结肾移植术后发生恶性肿瘤的诊治体会。方法：对我院于2000年1月至2009年6月行同种异体肾移植术的367例（其中包括38例活体供肾移植）进行了回顾性分析。共发生恶性肿瘤7例，其中2例原榆尿管肿瘤，3例膀胱肿瘤，1例肝癌，1例子宫内膜癌。2例原输尿管肿瘤中，1例行肾、输尿管全程及膀胱部分切除术．1例多次复发行输尿管腔镜内切除；3例膀胱癌中，2例行经尿道膀胱肿瘤电切术，术后配合膀胱灌注化疗，1例行膀胱全切术；1例肝癌行肝动脉导管介入治疗，1例子宫内膜癌行子宫全切术；手术后均适当调整免疫抑制方案。结果：1例输尿管肿瘤多次复发，最后肿瘤转移死亡，其余6例随访中均未见异常。移植肾功能正常。结论：肾移植后恶性肿瘤发病率增高，我国以泌尿系肿瘤为主。早期诊断及正规治疗是提高肿瘤治愈及延长患者生存的关键。

Objective To summarize the experiences of diagnosis and treatment of malignant tumor in kidney recipients after renal transplantation. Methods The data from 367 patients underwent renal transplantation during 2000 to 2009 were collected, and retrospective analysis was performed on data from seven patients with malignant tumor after renal transplantation, including 2 with uretal tumor, 3 with bladder tumor, 1 with liver cancer and 1 with endometrial cancer. Corresponding surgical operations were performed on 7 patients. Results Six patients had satisfactory resuhs and normal renal functions during follow-up and 1 died of tumor metastasis. Conclusion Kidney recipients have high rates of malignant tumor, especially for urologic neoplasm in China. Early diagnosis and active treatment may be the key point for prolonging patients＇ lives.