Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, University of Washington, Seattle, Washington.
UW Medicine Cancer Vaccine Institute, University of Washington, Seattle, Washington.
Am J Transplant. 2019 May;19(5):1266-1277. doi: 10.1111/ajt.15292. Epub 2019 Apr 4.
Solid organ transplant (SOT) recipients have an approximately 2-fold greater risk of developing and dying from a malignancy compared to the general population. Among the gynecologic cancers, including uterine, cervical, vaginal, vulvar, and ovarian, the HPV-related cancers are known to increase among women posttransplant compared to women in the general population, but less is known about the risk of uterine and ovarian cancers. This review provides an overview of the epidemiology of gynecologic cancers after solid organ transplantation, as well as the pathophysiology, management, and specific risk factors associated with these cancers. Closer surveillance for cervical cancers is warranted and larger studies are needed to assess whether and how uterine and ovarian cancers are associated with excess incidence and mortality. Such studies may lead to improvements in screening, prevention, and treatment before and after transplantation.
实体器官移植(SOT)受者发生恶性肿瘤的风险比一般人群高约 2 倍,死于恶性肿瘤的风险也更高。在妇科癌症中,包括子宫癌、宫颈癌、阴道癌、外阴癌和卵巢癌,已知与 HPV 相关的癌症在移植后女性中比一般人群中的女性更为常见,但对于子宫癌和卵巢癌的风险了解较少。本综述概述了实体器官移植后妇科癌症的流行病学,以及这些癌症的病理生理学、管理和特定危险因素。有必要对宫颈癌进行更密切的监测,还需要进行更大规模的研究,以评估子宫癌和卵巢癌是否与发病率和死亡率过高有关,以及如何有关。此类研究可能会导致在移植前后改善筛查、预防和治疗。