肾移植术后肿瘤(附22例报告)  

Transplantation associated malignancies (report of 22 cases)

作　　者：郑军华[1] 闵志廉[1] 朱有华[1] 齐隽[1] 王立明[1] 王亚伟[1] 任吉忠[1] 徐丹凤[1] 周梅生[1] 余加仁[1] 董震[1] 

机构地区：[1]上海第二军医大学长征医院泌尿外科

出　　处：《中华泌尿外科杂志》1999年第6期345-347,共3页Chinese Journal of Urology

摘　　要：目的探讨肾移植术后肿瘤发生情况和防治措施。方法对１９７８年６月～１９９８年５月行同种异体肾移植１６２４次／１５４７人术后肿瘤发生情况和免疫抑制剂使用进行回顾性分析。结果本组发现恶性肿瘤２２例，发生率为１４２％。分别发生于移植术后６个月～１０年，平均４８年。其中皮肤癌８例，肝右叶囊性腺癌１例，肝细胞癌２例，胃癌１例，直肠癌１例，结肠癌２例，回盲部腺癌１例，肾盂移行上皮癌２例，膀胱平滑肌肉瘤１例，肺恶性淋巴瘤１例，乳癌１例，口唇鳞癌１例。１６例行手术治疗，现存活１３例。６例属病变晚期，短期内死亡。结论肾移植术后免疫抑制剂的使用与肿瘤发生密切相关，应定期评估移植受者的免疫状态，早期发现肿瘤，并及时手术治疗，并减少免疫抑制剂用量。Objective To investigate the occurrence of malignancies after renal transplantation. Methods A retrospective study of 1 624 renal transplantations in 1 547 patients undertaken between June of 1978 and May of 1998 was carried out. ResultsZMalignant growth was noted after the transplantation in 22 (1.42%) patients occurred 6 months to 10 years postoperatively with an average of 4.8 years.There were 8 cases of carcinoma of skin,1 cystadenocarcinoma of lobus hepatis dexter,3 liver carcinoma,1 carcinoma of stomach,1 carcinoma of rectum, 2 carcinoma of colon,1 adenocarcinoma of cecum, 2 transitional cell carcinoma of renal pelvis,1 malignant lymphoma of lung,1 breast cancer and 1 carcinoma of lip.Surgical treatment was undertaken in 16,13 of them have been living and well.6 late cases died soon after the diagnosis. Conclusions The occurrence of malignant growth is intimately related to the use of immunosupresants.The immunological status of the patients after renal transplantation should be evaluated in follow up studies.Early detection of the transplantation associated malignant growth with prompt surgical management and reduction of the doses of immunosupresants are mandatory.

关 键 词：肾移植 术后 肿瘤 发生 预防 

分 类 号：R699.2[医药卫生—泌尿科学] R730.1[医药卫生—外科学]