Saeed Graham, Sanders Tierra, Tumin Dmitry, Obi Ogugua N, Oghoghorie Stanley, Ali Hassam, Adler Douglas G
Department of Internal Medicine, East Carolina University Brody School of Medicine (Graham Saeed, Stanley Oghoghorie).
Department of Pediatrics, East Carolina University Brody School of Medicine (Tierra Sanders, Dimitry Tumin).
Ann Gastroenterol. 2025 Jan-Feb;38(1):80-84. doi: 10.20524/aog.2024.0932. Epub 2024 Dec 12.
The risk of gastrointestinal (GI) cancer after lung transplantation (LTx) in sarcoidosis patients is not well defined. Given the cancer risks linked to sarcoidosis and organ transplantation, this study investigated the incidence of GI malignancies (DNM), comparing LTx recipients with sarcoidosis or idiopathic pulmonary fibrosis (IPF).
We analyzed data from the United Network for Organ Sharing registry, including adults with sarcoidosis or IPF who underwent LTx between May 2005 and December 2018. The primary outcome was the incidence of GI DNM by March 2023.
Of 7996 lung transplant recipients, 108 (1.35%) developed GI malignancies post-transplantation. Among these, 662 patients (9%) had sarcoidosis and 7334 (91%) had IPF. Sarcoidosis patients showed a non-significant trend toward a higher risk of GI malignancies compared to those with IPF (subhazard ratio 1.72, 95% confidence interval 0.90-3.29; P=0.099), with no observed difference in the risk of non-GI cancers.
The overall incidence of GI DNM following LTx is low, and sarcoidosis does not appear to increase the risk of GI cancers compared to IPF. This finding suggests that enhanced GI cancer screening beyond standard guidelines may not be warranted in this population, allowing for targeted surveillance of more prevalent malignancies in sarcoidosis patients post-LTx.
结节病患者肺移植（LTx）后发生胃肠道（GI）癌症的风险尚不明确。鉴于结节病和器官移植相关的癌症风险，本研究调查了胃肠道恶性肿瘤（DNM）的发生率，比较了结节病或特发性肺纤维化（IPF）的肺移植受者。
我们分析了器官共享联合网络登记处的数据，包括2005年5月至2018年12月期间接受肺移植的结节病或IPF成人患者。主要结局是截至2023年3月胃肠道DNM的发生率。
在7996例肺移植受者中，108例（1.35%）在移植后发生了胃肠道恶性肿瘤。其中，662例患者（9%）患有结节病，7334例（91%）患有IPF。与IPF患者相比，结节病患者发生胃肠道恶性肿瘤的风险有升高趋势，但无统计学意义（亚风险比1.72，95%置信区间0.90-3.29；P=0.099），非胃肠道癌症风险无差异。
肺移植后胃肠道DNM的总体发生率较低，与IPF相比，结节病似乎不会增加胃肠道癌症的风险。这一发现表明，在该人群中，超出标准指南的强化胃肠道癌症筛查可能没有必要，可对结节病肺移植后患者中更常见的恶性肿瘤进行有针对性的监测。
