University of Alabama, Birmingham, AL, USA.
Int Urol Nephrol. 2011 Sep;43(3):681-6. doi: 10.1007/s11255-011-9907-z. Epub 2011 Mar 4.
After solid organ transplantation, risk of cancer varies significantly based on cancer type. In this study, we determine the incidence of urothelial cancers (bladder and kidney) after renal transplantation from a single high-volume transplantation institution. In addition, we analyze the risk factors and review outcomes from the patients.
We performed a retrospective review of all patients in the University of Alabama at Birmingham (UAB) transplant database to identify all patients who received renal transplants at UAB between January 1, 1990, and January 1, 2010. We further identified transplant patients diagnosed with bladder, urothelial of other cancers in the same time period. We also examined tumor-specific variables such as presentation, clinical and pathologic staging, treatment type, recurrence, progression, interval to recurrence and progression, cancer-specific mortality, and interval from time to diagnosis to death.
Review of the transplant database confirmed 5,920 renal transplants. Thirteen patients underwent the diagnosis of urothelial cancer, providing an incidence of 0.2%. Eight patients had bladder cancer for an incidence of 0.13%, compared to an incidence of 0.02% among the general population. Patients diagnosed with bladder cancer after renal transplantation were younger than those in the general population and frequently present with more advanced and aggressive disease.
Patients are at an elevated risk of urothelial cancers after renal transplantation probably from immune suppression.
在实体器官移植后，癌症的风险因癌症类型而有显著差异。在这项研究中，我们确定了来自单一高容量移植机构的肾移植后尿路上皮癌（膀胱和肾脏）的发病率。此外，我们分析了这些患者的风险因素并回顾了他们的结局。
我们对阿拉巴马大学伯明翰分校（UAB）移植数据库中的所有患者进行了回顾性分析，以确定在 1990 年 1 月 1 日至 2010 年 1 月 1 日期间在 UAB 接受肾移植的所有患者。我们进一步确定了在同一时期被诊断为膀胱癌、尿路上皮癌或其他癌症的移植患者。我们还检查了肿瘤特异性变量，如表现、临床和病理分期、治疗类型、复发、进展、复发和进展的间隔时间、癌症特异性死亡率以及从诊断到死亡的时间间隔。
对移植数据库的审查证实了 5920 例肾移植。13 名患者被诊断为尿路上皮癌，发病率为 0.2%。8 名患者患有膀胱癌，发病率为 0.13%，而普通人群的发病率为 0.02%。在肾移植后被诊断为膀胱癌的患者比普通人群更年轻，且常伴有更晚期和侵袭性疾病。
肾移植后患者发生尿路上皮癌的风险增加，可能是由于免疫抑制。
