Statistics and Clinical Audit, NHS Blood and Transplant, Bristol BS34 8RR, UK.
Am J Transplant. 2010 Aug;10(8):1889-96. doi: 10.1111/j.1600-6143.2010.03181.x.
An increased incidence of malignancy is an established complication of organ transplantation and the associated immunosuppression. In this study on cancer incidence in solid organ transplant recipients in Britain, we describe the incidence of de novo cancers in the allograft recipient, and compare these incidences following the transplantation of different organs. Data in the UK Transplant Registry held by NHS Blood and Transplant (NHSBT) were linked with data made available by the cancer registries in England, Scotland and Wales. Incidence rates in the transplanted population were then compared with the general population, using standardized incidence ratios matched for age, gender and time period. The 10-year incidence of de novo cancer in transplant recipients is twice that of the general population, with the incidence of nonmelanoma skin cancer being 13 times greater. Nonmelanoma skin cancer, cancer of the lip, posttransplant lymphoproliferative disease and anal cancer have the largest standardized incidence ratios, but the incidence of different types of malignancy differs according to the organ transplanted. Patterns in standardized incidence ratios over time since transplantation are different for different types of transplant recipient, as well as for different malignancies. These results have implications for a national screening program.
恶性肿瘤发病率增加是器官移植和相关免疫抑制的既定并发症。在这项英国实体器官移植受者癌症发病率的研究中,我们描述了同种异体移植物受者新发癌症的发病率,并比较了不同器官移植后的发病率。英国国民保健署血液与移植(NHSBT)持有的英国移植登记处的数据与英格兰、苏格兰和威尔士癌症登记处提供的数据相关联。然后,使用按年龄、性别和时间段匹配的标准化发病率比,将移植人群的发病率与普通人群进行比较。移植受者新发癌症的 10 年发病率是普通人群的两倍,非黑色素瘤皮肤癌的发病率高 13 倍。非黑色素瘤皮肤癌、唇癌、移植后淋巴组织增生性疾病和肛门癌的标准化发病率比最高,但不同类型的恶性肿瘤的发病率因移植的器官而异。不同类型的移植受者以及不同的恶性肿瘤,随着时间推移,标准化发病率比的模式也不同。这些结果对国家筛查计划具有重要意义。