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肾移植受者原发性肾细胞癌:单中心经验

Renal Cell Carcinoma of Native Kidneys in Renal Transplant Recipients: A Single-center Experience.

作者信息

Moris Demetrios, Kakavia Kiriaki, Argyrou Chrysoula, Garmpis Nikolaos, Bokos John, Vernadakis Spyridon, Diles Konstantinos, Sotirchos Georgios, Boletis John, Zavos Georgios

机构信息

Transplantation Unit, Laikon General Hospital, Athens, Greece

Transplantation Unit, Laikon General Hospital, Athens, Greece.

出版信息

Anticancer Res. 2017 Feb;37(2):773-779. doi: 10.21873/anticanres.11376.

Abstract

BACKGROUND

The risk of renal cell carcinoma (RCC) development in renal transplant recipients is 15-100 times higher than in the general population. The majority of RCCs found in renal transplant recipients develop in the recipient's native kidneys, only 9% of tumors develop in the allograft itself. The mechanisms of development of RCC in native kidneys and renal allografts are not completely understood. We present our experience in renal transplant recipients with RCC of native kidneys providing valuable and clinically applicable treatment and follow-up data.

PATIENTS AND METHODS

The records of 2,173 patients who underwent renal transplantation in our Department between March 1983 and December 2015 were retrospectively reviewed. Using these data, we analyzed the incidence and types of post-transplant RCCs, as well as their clinical courses, focusing on native malignancies.

RESULTS

We found 11 RCCs (0.5%) during the observation period in native kidneys. The mean (±SD) follow-up period was 50.54±32.80 months. Four patients died during this period (36.4%).

CONCLUSION

Most RCCs in renal transplant recipients are low-stage, low-grade tumors with a favorable prognosis. Their diagnosis is usually incidental. RCC development in the native kidney of renal transplant recipients is an early event, frequently observed within 4 to 5 years after transplantation. The different natural history of these tumors is still undefined. Further research is needed to determine whether these differences are due to particular molecular pathways or to biases in relation to the mode of diagnosis.

摘要

背景

肾移植受者发生肾细胞癌(RCC)的风险比普通人群高15至100倍。在肾移植受者中发现的大多数RCC发生在受者的原生肾中,只有9%的肿瘤发生在移植肾本身。原生肾和移植肾中RCC的发生机制尚未完全明确。我们介绍了我们在肾移植受者原生肾RCC方面的经验,提供了有价值且临床适用的治疗和随访数据。

患者与方法

回顾性分析了1983年3月至2015年12月在我科接受肾移植的2173例患者的记录。利用这些数据,我们分析了移植后RCC的发病率和类型,以及它们的临床病程,重点关注原生恶性肿瘤。

结果

在观察期内,我们在原生肾中发现了11例RCC(0.5%)。平均(±标准差)随访期为50.54±32.80个月。在此期间有4例患者死亡(36.4%)。

结论

肾移植受者中的大多数RCC为低分期、低级别肿瘤,预后良好。它们的诊断通常是偶然的。肾移植受者原生肾中RCC的发生是一个早期事件,常在移植后4至5年内出现。这些肿瘤不同的自然病程仍不明确。需要进一步研究以确定这些差异是由于特定的分子途径还是与诊断方式有关的偏差。

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