肺移植术后发生恶性肿瘤的研究进展  

Research progress on malignant tumor after lung transplantation

作　　者：李偲涵 唐宏涛 徐琳 王俊杰 姜凯元 严浩吉 李昊萱 郑翔匀 陈婷婷 付思怡 田东[2,3] Li Caihan;Tang Hongtao;Xu Lin;Wang Junjie;Jiang Kaiyuan;Yan Haoji;Li Haoxuan;Zheng Xiangyun;Chen Tingting;Fu Siyi;Tian Dong(Medical Imaging Key Laboratory of Sichuan Province,North Sichuan Medical College,Nanchong 637000,China;不详)

机构地区：[1]川北医学院医学影像四川省重点实验室,四川南充637000 [2]川北医学院附属医院心肺移植研究室 [3]川北医学院附属医院院士(专家)工作站

出　　处：《器官移植》2021年第5期624-629,共6页Organ Transplantation

基　　金：医学影像四川省重点实验室开放课题(MIKLSP202007);四川省医学科研青年创新课题(Q18042);南充市市校合作科研专项(19SXHZ0189);川北医学院附属医院科研发展计划项目(2021ZK003)。

摘　　要：肺移植已经成为终末期肺病的最有效治疗手段。随着肺移植技术以及围手术期管理的不断优化,移植术后早期疗效已有明显改善,但远期预后仍不乐观。威胁受者远期生存的因素除了常见的慢性移植肺功能障碍,还包括术后恶性肿瘤。肺移植术后常见的恶性肿瘤包括非黑色素瘤皮肤癌、移植后淋巴组织增生性疾病和肺癌。实体器官移植术后绝大部分受者需要接受终身免疫抑制治疗,而肺移植受者接受的免疫抑制强度普遍高于其他器官移植受者。免疫抑制是导致受者抗肿瘤免疫监视功能受损和促进恶性肿瘤发生发展的主要因素。本文就肺移植术后最常见的几大恶性肿瘤的危险因素、预防及治疗方式做一综述,旨在为肺移植术后恶性肿瘤的综合诊治提供参考依据。Lung transplantation has become the most effective treatment of end-stage lung diseases.Along with persistent optimization of lung transplantation technique and perioperative management,the short-term clinical efficacy after lung transplantation has been significantly improved,whereas the long-term clinical prognosis remains unoptimistic.Besides chronic lung allograft dysfunction,postoperative malignant tumors also threaten the long-term survival of the recipients.Common malignant tumors following lung transplantation include nonmelanoma skin cancer,posttransplant lymphoproliferative disease and lung cancer.After solid organ transplantation,a large majority of the recipients require lifelong immunosuppressive therapy.The intensity of immunosuppressive therapy for the lung transplant recipients is generally higher than other organ transplant recipients.Immunosuppression is the main factor which leads to the impairment of anti-tumor immune monitoring function and promotes the incidence and development of malignant tumors.In this article,the risk factors,prevention and treatment of the most common malignant tumors after lung transplantation were reviewed,aiming to provide reference for comprehensive diagnosis and treatment of malignant tumors following lung transplantation.

关 键 词：肺移植 恶性肿瘤 非黑色素瘤皮肤癌 移植后淋巴组织增生性疾病 肺癌 免疫抑制 危险因素 程序性细胞死亡蛋白1 西米普利单抗 

分 类 号：R617[医药卫生—外科学] R73[医药卫生—临床医学]