Ivanovski N, Popov Z, Kolevski P, Cakalaroski K, Antova Z, Spasovski G, Vlckova-Laskovska M, Zografski G
Centre hospitalier universitaire Skopje, clinique de néphrologie, unité de transplantation, Skopje, République de Macédoine.
Ann Urol (Paris). 2000 Oct;34(5):336-9.
Between 1977-1998 we followed up 115 patients with renal allograft. Seventy patients had received a graft from a living donor, while 45 had received a graft from a cadaver donor. The immunosuppressive therapy included azathioprin (AZA), prednisolone (PRED) and cyclosporin A (CyA) in 90 patients and AZA and PRED in 25 patients. Nine patients showed skin malignancies (7.3%), three of these patients had Kaposi's sarcoma and the other six patients squamous or basal cell carcinoma. All cases were clinically and histologically confirmed. Squamous or basal cell carcinoma occurred mostly on the head and was radiosensitive, though recurrences might be observed. Kaposi's sarcoma was localized on either the lower extremities or the face. The condition of two patients treated by radiotherapy only partially improved. Due to chronic renal allograft rejection immunosuppressive therapy was withdrawn in two patients and dialysis was restarted without any other recurrence of the sarcoma. The rate of cancer occurrence in patients with renal allograft is consistent with the findings of other authors. Reduction or withdrawal of immunosuppressive therapy may have a beneficial effect on malignancy, but incurs the risk of losing the allograft.
1977年至1998年间，我们对115例肾移植患者进行了随访。70例患者接受了活体供体的移植，45例患者接受了尸体供体的移植。免疫抑制治疗包括90例患者使用硫唑嘌呤（AZA）、泼尼松龙（PRED）和环孢素A（CyA），25例患者使用AZA和PRED。9例患者出现皮肤恶性肿瘤（7.3%），其中3例患有卡波西肉瘤，另外6例患有鳞状或基底细胞癌。所有病例均经临床和组织学确诊。鳞状或基底细胞癌大多发生在头部，对放疗敏感，不过可能会观察到复发。卡波西肉瘤局限于下肢或面部。仅接受放疗的2例患者病情仅部分改善。由于慢性肾移植排斥反应，2例患者停用免疫抑制治疗并重新开始透析，肉瘤未再复发。肾移植患者的癌症发生率与其他作者的研究结果一致。减少或停用免疫抑制治疗可能对恶性肿瘤有有益影响，但会有失去移植肾的风险。
