摘要
目的 :探讨同种异体肾移植受者并发恶性肿瘤的临床情况。 方法 :回顾分析我院 1 977年 7月～1 999年 1 2月 898例 (90 3例次 )肾移植受者术后并发恶性肿瘤及其治疗。 结果 :术后发生恶性肿瘤 5例 ,发生率为 0 6 %。其中膀胱肿瘤 2例 ,肝癌 1例 ,Kaposi’s肉瘤 1例 ,非何杰金淋巴瘤 1例。平均年龄 5 6 6± 3 7岁。移植术后至肿瘤诊断时间 8～ 48(平均 2 7± 1 7)个月。诊断肿瘤时 5例患者肾功能正常 ,未有远处转移。经根治性手术切除肿瘤为主的综合治疗 ,包括减少免疫抑制剂用量 ,5例患者全部治愈。经随访 1 1～ 5 0 (平均 2 8± 1 5 )个月 ,肿瘤无复发 ,肾功能正常 ,无排斥反应发生。 结论 :肾移植患者恶性肿瘤的发生及种类与国外有较大区别。早期诊断 ,早期治疗是提高治愈率的关键。根治性手术切除肿瘤应为首选 ,同时减少免疫抑制剂用量。
OBJECTIVE To analyze the epidemiographic features of malignancy in renal allograft recipients in a single center. METHODOLOGY This analysis included 898 patients who received renal allografts between July 1997 and December 1999 and anti rejection treatment for at least 3 months. RESULTS After transplantation among the 898 recipients,5(a incidence about 0 6%)were diagnosed with malignancies that included bladder transitional cell carcinoma,squamous bladder cell carcinoma,primary liver cell carcinoma,non Hodgkins lymphoma,Kaposis sarcoma.The mean age at diagnosis of malignancy was 56 6±3 7(range 51 56)years,and the mean duration of immunosuppressive treatment 27±17(range 8 48)months.Four of the patients were on cyclosporin azathioprine prednisolone,and one on cyclosporin mofetil prednisolone regime.The treatments for malignancies consisted of completely removal of tumor mass,decrement of immunosuppressive treatment(cyclosporin by 1/2 1/3,azathioprine/mofetil by 1/2 or withdrawal),chemotherapy or radiotherpay,and traditional Chinese medicine.All the five cases were cured and have been followed up for 28±15(range 11 50)months without malignance recurrence,allograft dysfunction,or episode of rejection. CONCLUSION Malignance is an important complication in renal transplantation.Strict follow up and early diagnosis are critical.
出处
《肾脏病与透析肾移植杂志》
CAS
CSCD
2000年第3期226-228,共3页
Chinese Journal of Nephrology,Dialysis & Transplantation
关键词
肾移植
免疫抑制
肿瘤
neoplasm immuinosuppression renal transplantation
