Srisuwarn Praopilad, Sutharattanapong Napun, Disthabanchong Sinee, Kantachuvesiri Surasak, Kitiyakara Chagriya, Phakdeekitcharoen Bunyong, Ingsathit Atiporn, Sumethkul Vasant
Department of Medicine, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand.
Division of Nephrology, Department of Medicine, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand.
Transpl Int. 2024 Feb 26;37:11614. doi: 10.3389/ti.2024.11614. eCollection 2024.
Kidney transplant recipients (KTRs) are at increased risk of developing post-transplant malignancies (PTMs), with regional differences in types with excess risk compared to the general population. A single-center, population-controlled, retrospective cohort study was conducted at a tertiary care center in Thailand among all adults who underwent their first kidney transplant from 1986 to 2018. Standardized incidence ratios (SIRs) of malignancy by age, sex, and place of residence were obtained using data from the National Cancer Registry of Thailand as population control. There were 2,024 KTRs [mean age, 42.4 years (SD 11.4); female patients, 38.6%] during 16,495 person-years at risk. Of these, 125 patients (6.2%) developed 133 PTMs. The SIR for all PTMs was 3.85 (95% CI 3.22, 4.56), and for pooled solid and hematologic PTMs, it was 3.32 (95% CI 2.73, 3.99). Urothelial malignancies had the largest excess risk, especially in women [female SIR 114.7 (95% CI 66.8, 183.6); male SIR 17.5 (95% CI 8.72, 31.2)]. The next two most common cancers were non-Hodgkin's lymphoma and skin cancer [SIR 20.3 (95% CI 13.6, 29.1) and 24.7 (95% CI 15.3-37.8), respectively]. Future studies are needed to identify the risk factors and assess the need for systematic screening among PTMs with excess risk in KTRs.
肾移植受者（KTRs）发生移植后恶性肿瘤（PTMs）的风险增加，与普通人群相比，不同类型的PTMs存在地区差异。在泰国的一家三级医疗中心，对1986年至2018年期间接受首次肾移植的所有成年人进行了一项单中心、人群对照的回顾性队列研究。以泰国国家癌症登记处的数据作为人群对照，获得了按年龄、性别和居住地划分的恶性肿瘤标准化发病率（SIRs）。在16495人年的风险期内，共有2024名KTRs[平均年龄42.4岁（标准差11.4）；女性患者占38.6%]。其中，125名患者（6.2%）发生了133例PTMs。所有PTMs的SIR为3.85（95%CI 3.22，4.56），实体和血液系统PTMs合并后的SIR为3.32（95%CI 2.73，3.99）。尿路上皮恶性肿瘤的额外风险最大，尤其是在女性中[女性SIR 114.7（95%CI 66.8，183.6）；男性SIR 17.5（95%CI 8.72，31.2）]。接下来两种最常见的癌症是非霍奇金淋巴瘤和皮肤癌[SIR分别为20.3（95%CI 13.6，29.1）和24.7（95%CI 15.3 - 37.8）]。未来需要开展研究以确定风险因素，并评估对KTRs中存在额外风险的PTMs进行系统筛查的必要性。
