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肺移植后肺癌:发病率和结局。

Lung cancer in lung transplantation: incidence and outcome.

机构信息

Department of Medical Oncology, Hospital Universitario Puerta de Hierro Majadahonda, Madrid, Spain.

Department of Pulmonology, Hospital Universitario Puerta de Hierro Majadahonda, Madrid, Spain.

出版信息

Postgrad Med J. 2018 Jan;94(1107):15-19. doi: 10.1136/postgradmedj-2017-134868. Epub 2017 Aug 4.

Abstract

INTRODUCTION

Malignancies are one of the causes of mortality after lung transplantation. However, little is known about lung cancer outcome after lung transplantation.

METHODS

We performed a retrospective search of the lung transplantation database at our institution to identify patients diagnosed with lung cancer after lung transplantation.

RESULTS

Out of 633 lung transplant patients, lung cancer was detected in 23 of them (3.63%). The most common causes for transplantation were idiopathic pulmonary fibrosis (47.8%) and emphysema (43.4%). A total of 18 patients were diagnosed during follow-up, 12 cases in the native lung (52.2%) and 6 cases in the donor lung (26.1%). The diagnosis was evidenced in the explanted lung in five patients (21.7%). The median of time from transplantation to cancer diagnosis was 39.7 months (24.356.6). Lung cancer was the cause of death in 16 patients. Survival rate at1year from diagnosis of lung cancer was 45.64% (95% CI 0.2431 to 0.6473).

CONCLUSIONS

Lung transplant recipients constitute a high-risk group for developing lung cancer. Among our patients, lung cancer was predominantly diagnosed in the native lung and at an advanced stage. The primary tumour was the main cause of death in most of these patients.

摘要

简介

恶性肿瘤是肺移植后死亡的原因之一。然而,人们对肺移植后肺癌的结果知之甚少。

方法

我们对本机构的肺移植数据库进行了回顾性检索,以确定肺移植后被诊断为肺癌的患者。

结果

在 633 例肺移植患者中,有 23 例(3.63%)被诊断为肺癌。移植的最常见原因是特发性肺纤维化(47.8%)和肺气肿(43.4%)。共有 18 例患者在随访中被诊断为肺癌,其中 12 例在原生肺(52.2%),6 例在供体肺(26.1%)。5 例(21.7%)患者的诊断证据来自移植肺。从移植到癌症诊断的中位时间为 39.7 个月(24.356.6)。16 例患者死于肺癌。肺癌诊断后 1 年的生存率为 45.64%(95%CI 0.2431 至 0.6473)。

结论

肺移植受者是罹患肺癌的高危人群。在我们的患者中,肺癌主要在原生肺中被诊断出来,且处于晚期。在大多数此类患者中,原发性肿瘤是主要死因。

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