肾移植术后并发恶性肿瘤6例报告

Malignancy after renal transplantation:report of 6 cases

目的 提高肾移植术后发生恶性肿瘤的诊疗水平。方法 结合文献回顾性分析我院肾移植术后发生的 6例恶性肿瘤的诊疗资料。结果 10 0 2例肾移植受者术后共发生恶性肿瘤 6例 ,发生时间于移植术后 9～ 96 (平均 4 7.2 )个月 ,其中左肾透明细胞癌 1例、膀胱癌 2例、食道癌 1例、皮肤癌 1例、肝癌 1例。 4例手术治疗 ,3例无瘤存活至今 ,1例术后肺广泛转移死亡。 1例放疗 ,生存一年后癌转移死亡 ,1例未手术者于短期内癌广泛转移死亡。结论 肾移植受者术后免疫功能低下 ,容易发生恶性肿瘤 ,随诊时应引起足够的重视。早期发现、早期治疗 ,减少免疫抑制剂用量可取得较好疗效。

Objective To improve the diagnosis and treatment of malignancy after renal transplantation. Methods A total of 6 cases of malignancies after renal transplantation were retrospectively analysed with review of the literature. Results From 1978 to 2001, 1 002 cases of cadaveric kidney transplantation were performed in our hospital. Six cases of malignancy occurred 9 to 96 months posttransplantation with an average of 47.2 months. There were 2 cases of transitional cell carcinoma of bladder, 1 clear cell carcinoma of kidney, 1 squamous cell carcinoma of esophagus, 1 carcinoma of skin, 1 liver carcinoma. Surgical treatment was given to 4 patients, 3 of whom have been survived and tumor free. The other died of wide metastasis. Conclusion The high incidence of malignancy after renal transplantation is related to the use of immunosuppresants. Early diagnosis, prompt surgery and reduction of immunosuppresants may be useful for effective therapy.