Yin Wen-Yao, Lee Ming-Che, Lai Ning-Sheng, Lu Ming-Chi
Division of General Surgery, Buddhist Dalin Tzu Chi General Hospital, Chia-Yi, Taiwan; School of Medicine, Tzu Chi University, Hualien, Taiwan.
School of Medicine, Tzu Chi University, Hualien, Taiwan; Department of General Surgery, Buddhist Tzu Chi General Hospital, Hualien, Taiwan.
J Formos Med Assoc. 2015 Apr;114(4):373-4. doi: 10.1016/j.jfma.2012.02.019. Epub 2012 Jun 7.
Renal transplant patients have high risk for bladder cancer. The reactivation of BK virus is common in renal transplant patients especially in the urinary tract. There was some evidence suggesting that the reactivation of BK virus (BKV) in renal transplant patients may associate with the development of bladder cancer. Here we demonstrated that a patient that had persistent elevated BKV viruria (urine BKV DNA concentration more than 10(11) copies/ml) after renal transplantation. Then, bladder cancer was found in 13 months after kidney transplantation. The urine BKV DNA concentration was detected by real-time PCR and the BKV DNA in the bladder tumor was detected by PCR. BKV DNA was found in the marginal and central part of the bladder tumor. After removal of the bladder cancer, the urine BKV viral load in this patients dropped dramatically to <10(2) copies/ml. However, the urine viral load had increased modestly to 10(6) copies/ml in 3 months after surgery. Since there is a close correlation between the urine BK viral load and the presence of bladder cancer, we suggested that there might be a causal relationship between the reactivation of BKV and the development of bladder cancer in renal transplant patient.
肾移植患者患膀胱癌的风险很高。BK病毒再激活在肾移植患者中很常见,尤其是在泌尿道。有一些证据表明,肾移植患者中BK病毒(BKV)的再激活可能与膀胱癌的发生有关。在此我们证明了一名肾移植患者在肾移植后持续出现BKV病毒尿升高(尿BKV DNA浓度超过10¹¹拷贝/毫升)。然后,在肾移植13个月后发现了膀胱癌。通过实时PCR检测尿BKV DNA浓度,通过PCR检测膀胱肿瘤中的BKV DNA。在膀胱肿瘤的边缘和中央部分发现了BKV DNA。切除膀胱癌后,该患者的尿BKV病毒载量急剧下降至<10²拷贝/毫升。然而,术后3个月尿病毒载量适度增加至10⁶拷贝/毫升。由于尿BK病毒载量与膀胱癌的存在密切相关,我们认为BKV再激活与肾移植患者膀胱癌的发生之间可能存在因果关系。