Vallejo Gonzalo Hernández, Romero Carlos Jiménez, de Vicente Juan Carlos
Department of Oral Medicine and Surgery, School of Dentistry, Complutense University, Madrid, Spain.
Crit Rev Oncol Hematol. 2005 Oct;56(1):87-99. doi: 10.1016/j.critrevonc.2004.12.011.
De novo tumors (DNT) are a serious complication after orthotopic liver transplantation (OLT), showing a higher overall incidence ranging from 4.7% to 15.7% in non-selected series. Skin cancer (SC) is the most frequent malignancy observed, ranging from 6% to 70% of the tumors observed, followed by post-transplant lymphoproliferative disorders (PTLD) (4.3-30%). Different immunosuppressive protocols do not seem to influence DNT appearance. Colon and upper aerodigestive cancer after OLT seems to be more prone to develop when there are associated risk factors, such as primary sclerosing cholangitis (PSC) and alcoholic liver cirrhosis (ALC). Some risk factors, such as age, smoking, alcohol and others seem to play a role in higher risk for malignancy, but the presence of a long-term immunosuppressive state, more than the specific regimen used, is the basis for this higher incidence. Ethnic and demographic factors are also important variables influencing the heterogeneity of the results, especially influencing Kaposi's sarcoma and skin tumors.
新发肿瘤（DNT）是原位肝移植（OLT）后的一种严重并发症，在未筛选的系列研究中，其总体发病率较高，范围在4.7%至15.7%之间。皮肤癌（SC）是观察到的最常见恶性肿瘤，在所观察到的肿瘤中占6%至70%，其次是移植后淋巴细胞增生性疾病（PTLD）（4.3 - 30%）。不同的免疫抑制方案似乎并不影响DNT的出现。OLT后结肠癌和上消化道癌在存在相关危险因素时，如原发性硬化性胆管炎（PSC）和酒精性肝硬化（ALC），似乎更容易发生。一些危险因素，如年龄、吸烟、饮酒等，似乎在恶性肿瘤风险较高中起作用，但长期免疫抑制状态的存在，而非所使用的具体方案，是这种较高发病率的基础。种族和人口统计学因素也是影响结果异质性的重要变量，尤其影响卡波西肉瘤和皮肤肿瘤。
