Manickavasagar Revathy, Thuraisingham Raj
Royal London Hospital, London, UK
Royal London Hospital, London, UK.
Clin Med (Lond). 2020 Mar;20(2):142-145. doi: 10.7861/clinmed.2019-0423.
It is well recognised that kidney transplant recipients have an increased risk of cancers compared with the age and gender matched general population. Malignancy is one of the commonest causes of death among this cohort after cardiovascular disease. This increased risk is largely attributable to the effect of immunosuppression, which impairs T cell function, immunosurveillance and the immunological control of oncogenic viral infections. Cancer related mortality rates are also higher in solid organ transplant recipients compared with the general population. While early diagnosis may improve outcomes in these patients, cancer screening is debatable given the lack of randomised controlled trials in this cohort, and treatment is often challenging. This article reviews the epidemiology and risk factors for the development of malignancy in the post-transplant setting, as well as screening guidelines for specific malignancies of which patients are at particular risk.
众所周知，与年龄和性别匹配的普通人群相比，肾移植受者患癌症的风险更高。恶性肿瘤是该队列中心血管疾病之后最常见的死亡原因之一。这种风险增加很大程度上归因于免疫抑制的作用，免疫抑制会损害T细胞功能、免疫监视以及对致癌病毒感染的免疫控制。实体器官移植受者的癌症相关死亡率也高于普通人群。虽然早期诊断可能会改善这些患者的预后，但鉴于该队列缺乏随机对照试验，癌症筛查存在争议，而且治疗往往具有挑战性。本文综述了移植后发生恶性肿瘤的流行病学和危险因素，以及针对患者特别易患的特定恶性肿瘤的筛查指南。
