肾移植术后恶性肿瘤47例分析

Analysis of 47 cases of malignant tumors in kidney transplantation recipients

目的 了解恶性肿瘤在肾移植患者中的发病率 ,并探讨其发病率增高的机理。方法 回顾性分析 1978～ 2 0 0 0年 6月间接受免疫抑制治疗 (至少半年 )的肾移植患者中发生恶性肿瘤的病例。结果 在 112 0例肾移植患者中 ,发生恶性肿瘤 47例 ,其中 40例资料完整 ,34例得到病理证实。恶性肿瘤发病率为 4.2 %。肿瘤治疗以手术治疗为主 ,辅以化疗和放疗、免疫治疗。有 2 5例至今存活 ,最长存活期达 4年半。结论 肾移植患者恶性肿瘤发生率明显高于一般人群。其机理除了应用免疫抑制治疗所带来的后果外 ,也不能忽视移植术本身带来的影响 ,如癌基因嵌合、致癌病毒的转移等。

Objective To study the incidence of malignant tumors in renal allografts and explore the mechanism of increased incidence.Methods A retrospective study was performed on 1 120 renal allografts under at least 0.5 year immunosuppression from 1978～2000. Results 47 cases of malignant tumors were found in 1 120 cases undergoing renal transplantation with the incidence being 4.2?%. 40 cases had intact medical history and 34 cases were demonstrated pathologically. Most patients accepted operations, additional therapies including chemical or radiological and immunological therapies. 25 cases survived and the longest survived time was 4.5 years. Conclusions The incidence of malignant tumors in renal allografts was higher than normal persons. Besides the outcome of immunosuppression, the effects of transplantation itself, such as oncogene chimera, transition of carcinogenic virus and so on, can not be neglected.