Stefoni S, Scolari M P, Sestigiani E, Faenza A, Campieri C, Buscaroli A, Liviano D'Arcangelo G, D'Addio F
Servizio di Nefrologia e Dialisi, Centro Trapianti di Rene, Policlinico S. Orsola - Malpighi, Universita' degli Studi di Bologna, Bologna, Italy.
G Ital Nefrol. 2002 Nov-Dec;19(6):650-7.
The prevalence of post-transplant malignancies, in renal transplant recipients, is higher than that expected in age and sex-matched controls from the general population, and there is a markedly increased incidence of certain cancers.
In 1137 renal transplant recipients (1020 from cadaveric and 117 from living donors, M/F 771/366) performed at the S. Orsola Renal Transplantation Centre since 10/1976 to 9/2001, we studied the post-transplant cancer prevalence, the correlation between cancer prevalence and population characteristics, the risk factors (smoke, cancer history, positive HBsAg and antiHCV infection) and the immunosuppressive therapy.
The prevalence of malignancies was 3.86% (52 malignancies in 44 patients). The period between transplant and diagnosis of malignant disease was 59 +/- 85 months. Skin cancer was the most common (n=16; 30.7%), followed by lymphoproliferative disorders (n=8; 15.4%), Kaposi s sarcoma (n=6; 11.5%), uterine cancer (n=6; 11.5%), renal carcinoma of native kidney (n=5; 9.6%), cancer of breast/stomach/pancreas and urinary bladder (n=2; 3.8%) and other cancers (n=5; 9.6%). The mean duration of dialysis before transplantation was longer in cancer patients (41+/- 32.1 vs. 33.5 +/- 32.4 months). We found a correlation between types of malignancies and viral infection in NH-lymphoma (EBV positive 4/4) and skin cancer (HZV positive 13/16). We also detected a correlation between Aza and skin cancer (16/22) and CyA and lymphoproliferative disorders (7/8).
肾移植受者移植后恶性肿瘤的患病率高于来自普通人群的年龄和性别匹配对照者所预期的患病率，且某些癌症的发病率显著增加。
在1976年10月至2001年9月期间于圣奥索拉肾移植中心进行肾移植的1137例受者（1020例来自尸体供者，117例来自活体供者，男/女为771/366）中，我们研究了移植后癌症患病率、癌症患病率与人群特征之间的相关性、危险因素（吸烟、癌症病史、乙肝表面抗原阳性和抗丙型肝炎病毒感染）以及免疫抑制治疗。
恶性肿瘤的患病率为3.86%（44例患者中有52例恶性肿瘤）。从移植到诊断出恶性疾病的时间为59±85个月。皮肤癌最为常见（n = 16；30.7%），其次是淋巴增生性疾病（n = 8；15.4%）、卡波西肉瘤（n = 6；11.5%）、子宫癌（n = 6；11.5%）、原肾肾癌（n = 5；9.6%）、乳腺/胃/胰腺和膀胱癌（n = 2；3.8%）以及其他癌症（n = 5；9.6%）。癌症患者移植前透析的平均时间更长（41±32.1 vs. 33.5±32.4个月）。我们发现NH淋巴瘤（EBV阳性4/4）和皮肤癌（HZV阳性13/16）中恶性肿瘤类型与病毒感染之间存在相关性。我们还检测到硫唑嘌呤与皮肤癌（16/22）以及环孢素A与淋巴增生性疾病（7/8）之间存在相关性。
