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实体器官移植后新发甲状腺癌——一家大型机构的25年经验及文献综述

De novo thyroid cancer following solid organ transplantation-A 25-year experience at a high-volume institution with a review of the literature.

作者信息

Kluijfhout Wouter P, Drake Frederick T, Pasternak Jesse D, Beninato Toni, Mitmaker Elliot J, Gosnell Jessica E, Shen Wen T, Suh Insoo, Freise Chris E, Duh Quan-Yang

机构信息

Section of Endocrine Surgery, University California San Francisco, San Francisco, California.

Department of Surgery, University Medical Center Utrecht, Utrecht, The Netherlands.

出版信息

J Surg Oncol. 2017 Feb;115(2):105-108. doi: 10.1002/jso.24495. Epub 2017 Jan 5.

Abstract

BACKGROUND AND OBJECTIVES

We investigated the rate, stage, and prognosis of thyroid cancer in patients after solid-organ transplantations, and compared this to the general population.

METHODS

We performed a retrospective review of patients who developed thyroid cancer after a solid-organ transplantation between January 1988 and December 2013 at a high volume transplant center. Standardized Incidence Ratio's (SIR) were calculated. Additionally, a systematic review of the literature was performed.

RESULTS

A total of 10,428 patients underwent solid organ transplantation. Eleven patients (11.4 per 100,000 person-years) developed thyroid cancer: six men and five women with a mean age at diagnosis of thyroid cancer of 58 years. Ten patients underwent surgery and had stage I thyroid cancer. One patient had recurrent disease after a mean follow-up time of 78 months. The SIR varied between 0.75 and 2.3. Seventeen studies were included in the systematic review with a SIR ranging from 2.5 to 35.

CONCLUSION

Rate of thyroid cancer is not significantly higher in patients who underwent solid organ transplantation compared to general population. Stage at presentation and prognosis also appear to be similar to that of the general population. Post-transplant screening for thyroid cancer remains debatable; however, when thyroid cancer is discovered, treatment should be similar to that of non-transplant patients. J. Surg. Oncol. 2017;115:105-108. © 2017 Wiley Periodicals, Inc.

摘要

背景与目的

我们调查了实体器官移植患者甲状腺癌的发病率、分期及预后,并与普通人群进行比较。

方法

我们对1988年1月至2013年12月间在一家大型移植中心接受实体器官移植后发生甲状腺癌的患者进行了回顾性研究。计算标准化发病率(SIR)。此外,还对文献进行了系统回顾。

结果

共有10428例患者接受了实体器官移植。11例患者(每10万人年11.4例)发生甲状腺癌:6例男性和5例女性,甲状腺癌诊断时的平均年龄为58岁。10例患者接受了手术,均为I期甲状腺癌。1例患者在平均随访78个月后出现复发。SIR在0.75至2.3之间。系统回顾纳入了17项研究,SIR范围为2.5至35。

结论

与普通人群相比,实体器官移植患者的甲状腺癌发病率没有显著升高。发病时的分期和预后似乎也与普通人群相似。移植后甲状腺癌筛查仍存在争议;然而,当发现甲状腺癌时,治疗应与非移植患者相似。《外科肿瘤学杂志》2017年;115:105 - 108。©2017威利期刊公司

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