Fairley C K, Sheil A G, McNeil J J, Ugoni A M, Disney A P, Giles G G, Amiss N
Department of Social and Preventive Medicine, Monash University, Alfred Hospital, Prahran, Victoria, Australia.
Clin Nephrol. 1994 Feb;41(2):101-5.
The incidence of anogenital malignancies is greatly increased in patients who have received a renal transplant, but this has not been well studied in patients receiving maintenance dialysis. Our aim was to assess the incidence of these malignancies in patients on dialysis and compare these to transplanted patients. The age standardized incidence ratio (SIR) for anogenital malignancies was calculated by comparing the observed number of malignancies to the expected number. The expected number was calculated by multiplying the age specific incidence rates for each malignancy by the person years at risk in 5-year age cohorts. Of 15,820 patients in the Australia and New Zealand data base, 8,215 had received a renal transplant. A total of 39,750 person years at risk were contributed by patients who had received a renal transplant, while 29,276 person years at risk were contributed by dialysis patients who had not received a renal transplant. For dialysis patients, vulval cancer occurred more commonly than expected (2 observed, 0.48 expected) giving a SIR of 4.2 (95% confidence interval = 0.4-11.9). Cervical cancer occurred less commonly with a SIR of 0.74 (95% Cl = 0.07-2.11). No cases of either anal or penile cancer occurred although these are rare tumors, with only 0.13 and 0.23 cases expected respectively. In transplant recipients 44 anogenital malignancies occurred while 4.3 could have been expected. The SIR ranged from 3.3 (95% Cl 1.7-5.8) for cervical cancer to 55.8 (95% Cl 35.8-83.0) for vulval cancer. To investigate the possible effect of chronic uremia before dialysis began, SIR was calculated to include an additional 24 months of observation before dialysis.(ABSTRACT TRUNCATED AT 250 WORDS)
接受肾移植的患者发生肛门生殖器恶性肿瘤的几率大幅增加，但对于接受维持性透析的患者，这方面尚未得到充分研究。我们的目的是评估透析患者中这些恶性肿瘤的发生率，并与肾移植患者进行比较。通过将观察到的恶性肿瘤病例数与预期病例数进行比较，计算肛门生殖器恶性肿瘤的年龄标准化发病率（SIR）。预期病例数通过将每种恶性肿瘤的年龄特异性发病率乘以5岁年龄组的风险人年数来计算。在澳大利亚和新西兰数据库的15820名患者中，8215人接受了肾移植。接受肾移植的患者共贡献了39750人年的风险，而未接受肾移植的透析患者贡献了29276人年的风险。对于透析患者，外阴癌的发生比预期更常见（观察到2例，预期0.48例），SIR为4.2（95%置信区间=0.4-11.9）。宫颈癌的发生较少，SIR为0.74（95%Cl=0.07-2.11）。虽然肛门癌和阴茎癌都是罕见肿瘤，预期分别只有0.13例和0.23例，但均未发生。在移植受者中，发生了44例肛门生殖器恶性肿瘤，而预期可能为4.3例。SIR范围从宫颈癌的3.3（95%Cl 1.7-5.8）到外阴癌的55.8（95%Cl 35.8-83.0）。为了研究透析开始前慢性尿毒症的可能影响，计算SIR时纳入了透析前额外24个月的观察期。（摘要截断于250字）
