肾移植术后恶性肿瘤的发病类型和治疗  

Occurrence,Types,and Therapies of Malignant Tumors in Recipients of Renal Transplantation

作　　者：刘广华[1] 李汉忠[1] 王惠君[1] 毛全宗[1] 夏溟[1] 谢燚[1] 薛翀[1] 王海[1] 纪志刚[1] 

机构地区：[1]中国医学科学院北京协和医学院北京协和医院泌尿外科,北京100730

出　　处：《中国医学科学院学报》2009年第3期288-291,共4页Acta Academiae Medicinae Sinicae

摘　　要：目的探讨肾移植术后恶性肿瘤的发病类型及治疗效果。方法回顾性分析498例在北京协和医院泌尿外科接受肾移植手术受者术后恶性肿瘤发生及治疗情况。结果498例受者中,有18例(3.6%)发生恶性肿瘤,其中膀胱癌5例,肾盂癌及输尿管癌4例,白血病及淋巴瘤3例,肝癌2例,皮肤癌、直肠癌、肺癌、胸腺瘤各1例。10例经手术切除的肿瘤患者中,6例无复发,肾功能正常,移植肾无排斥反应;3例膀胱癌及1例输尿管癌术后7～15个月复发,其中1例膀胱癌死亡;1例肝癌术后8个月出现肺转移死亡。3例血液系统肿瘤行化疗,其中1例非霍奇金淋巴瘤治疗11个月后死亡;5例丧失手术机会者在诊断肿瘤后8～17个月死亡。结论肾移植患者恶性肿瘤发生率高于普通人群,其中以尿路上皮癌比例较高,实体肿瘤首选根治性手术切除术。Objective To investigate the types and therapies of malignancies in renal allograft recipients. Methods We retrospectively analyzed the occurrence, types, and therapies of malignancies in 498 renal allograft recipients who had received operations in Peking Union Medical College Hospital from May 1986 to October 2008. Results Among 498 renal allograft recipients, 18 patients （3.6 % ） were diagnosed with malignancies, which included bladder cancer （ n = 5 ） , renal pyloric cancer or ureteric cancer （ n = 4 ） , leukemia or lymphoma （ n = 3 ）, hepatic cancer （ n = 2）, skin cancer, rectum carcinoma , pulmonary carcinoma and thymoma （n = 1 each）. Surgical operations were performed in 10 cases, 6 of whom survived with normal renal function and had no rejection of transplanted kidneys. Three patients with bladder cancer and one patient with ureteric cancer experienced recurrences 7 to 15 months after operations; among them one bladder cancer patient died. One hepatic carcinoma patient died of pulmonary metastasis 8 months after operation. One non-Hodgkin＇s lymphoma patient died 11 months after chemotherapy. Five cases with advanced unresectable malignancies died 8 to 17 months after the diagnosis. Conclusions The incidences of malignancies, especially urological epithelial carcinoma, are high in renal allograft recipients. Radical surgery of the solid malignancies is a preferred option.

关 键 词：肾移植 恶性肿瘤 治疗 

分 类 号：R617[医药卫生—外科学]