1] State Key Laboratory of Reproductive Medicine, Institute of Toxicology, Nanjing Medical University, Nanjing, China [2] Key Laboratory of Modern Toxicology of Ministry of Education, School of Public Health, Nanjing Medical University, Nanjing, China.
Department of Neurosurgery, the First Affiliated Hospital, Nanjing Medical University, Nanjing, China.
Br J Cancer. 2014 Apr 2;110(7):1871-7. doi: 10.1038/bjc.2014.44. Epub 2014 Feb 4.
Renal transplantation has been associated with a significantly increased risk of developing cancers during long-term follow-up, but for bladder cancer, this risk is less clear. We therefore performed a meta-analysis to determine whether bladder cancer risk in renal transplant recipients was increased.
Eligible studies were identified through searches of PubMed and other public resources. Random-effects meta-analyses were used to pool overall estimates for standardised incidence ratios (SIRs). Heterogeneity test, sensitivity analysis, and assessment of publishing bias were also performed.
We identified a 3.18-fold higher SIR (95% confidence intervals (CI): 1.34-7.53, P=0.008) of bladder cancer in patients following renal transplantation compared with the general population, based on data from 79,988 patients with a total follow-up of 308,458 patient-years. When stratified by ethnicity, the SIRs for bladder cancer were 2.00 (95% CI: 1.51-2.65, P=0.001) and 14.74 (95% CI: 3.66-59.35, P<0.001) between European and Asian renal transplant recipients, respectively.
Our study demonstrated that the risk of developing bladder cancer in transplant populations was increased. Such association suggests that physicians should be more vigilant in checking for bladder cancer in transplantation recipient population.
肾移植后长期随访中发生癌症的风险显著增加,但膀胱癌的风险尚不清楚。因此,我们进行了一项荟萃分析,以确定肾移植受者膀胱癌的风险是否增加。
通过搜索 PubMed 和其他公共资源,确定了符合条件的研究。使用随机效应荟萃分析汇总标准化发病率比(SIR)的总体估计值。还进行了异质性检验、敏感性分析和发表偏倚评估。
根据 79988 名患者的随访数据(共 308458 人年),我们发现肾移植患者膀胱癌的 SIR 为 3.18 倍(95%置信区间:1.34-7.53,P=0.008),高于普通人群。按种族分层时,欧洲和亚洲肾移植受者的膀胱癌 SIR 分别为 2.00(95%置信区间:1.51-2.65,P=0.001)和 14.74(95%置信区间:3.66-59.35,P<0.001)。
我们的研究表明,移植人群发生膀胱癌的风险增加。这种关联表明,医生应更加警惕检查移植受者人群中的膀胱癌。