Marschalek Julian, Helmy Samir, Schmidt Alice, Polterauer Stephan, Sobulska Martha, Gyoeri Georg P, Grimm Christoph
Department of Gynecology and Gynecological Oncology, Gynecological Cancer Unit, Comprehensive Cancer Center, Medical University of Vienna, Vienna, Austria.
Division of Nephrology and Dialysis, Department of Medicine Ill, Medical University of Vienna, Vienna, Austria.
Acta Obstet Gynecol Scand. 2015 Aug;94(8):891-7. doi: 10.1111/aogs.12663. Epub 2015 May 23.
Renal transplant patients are at increased risk for human papillomavirus-related malignancies of the lower genital tract. Our aim was to describe the incidence of genital dysplasia, assess the most common cervical cancer screening intervals and identify independent risk factors for the development of genital dysplasia in renal transplant patients.
Retrospective, non-interventional study from two centers.
Post-transplant nephrologic follow-up visit at the Medical University of Vienna and a Viennese teaching hospital.
262 consecutive female renal transplant patients with renal transplant performed between 1980 and 2012 at the Medical University of Vienna.
Sociodemographic patient characteristics, frequency of gynecological examinations, histo- and cytopathological test results were collected.
Dysplasia rates in renal transplant patients.
16 patients (6.2%) with genital dysplasia after renal transplant were observed. The 1-year, 3-year and 10-year proportional incidence rates for genital dysplasia in general and cervical dysplasia in particular were 1.3 and 1.3%, 3.3 and 2.7%, and 13.6 and 12.0%, respectively. Patients attended cervical cancer screening on a regular basis once a year in 82.7% of cases. In multivariate analysis re-transplantation [odds ratio 12.1 (1.5-96.3)], and renal transplant at a young age [odds ratio 0.6 (0.4-0.9)] were identified as independent risk factors for the development of female genital dysplasia.
Female renal transplant patients have an increased risk for the development of genital dysplasia in general and of cervical dysplasia in particular. Within this cohort, women at a young age at the time of transplantation and after re-transplantation are at highest risk for the development of genital dysplasia.
肾移植患者发生人乳头瘤病毒相关下生殖道恶性肿瘤的风险增加。我们的目的是描述生殖器发育异常的发生率，评估最常见的宫颈癌筛查间隔，并确定肾移植患者发生生殖器发育异常的独立危险因素。
来自两个中心的回顾性、非干预性研究。
维也纳医科大学和维也纳一家教学医院的移植后肾病随访门诊。
1980年至2012年在维也纳医科大学连续进行肾移植的262例女性肾移植患者。
收集患者的社会人口学特征、妇科检查频率、组织病理学和细胞病理学检查结果。
肾移植患者的发育异常率。
观察到16例（6.2%）肾移植后发生生殖器发育异常的患者。总体生殖器发育异常以及尤其是宫颈发育异常的1年、3年和10年比例发病率分别为1.3%和1.3%、3.3%和2.7%、13.6%和12.0%。82.7%的病例中患者每年定期进行宫颈癌筛查。多变量分析显示再次移植[比值比12.1（1.5 - 96.3）]和年轻时进行肾移植[比值比0.6（0.4 - 0.9）]被确定为女性生殖器发育异常发生的独立危险因素。
女性肾移植患者总体发生生殖器发育异常尤其是宫颈发育异常的风险增加。在该队列中，移植时年龄较小以及再次移植后的女性发生生殖器发育异常的风险最高。
