Hoshida Y, Tsukuma H, Yasunaga Y, Xu N, Fujita M Q, Satoh T, Ichikawa Y, Kurihara K, Imanishi M, Matsuno T, Aozasa K
Department of Pathology, Osaka University Medical School, Suita, Japan.
Int J Cancer. 1997 May 16;71(4):517-20. doi: 10.1002/(sici)1097-0215(19970516)71:4<517::aid-ijc3>3.0.co;2-x.
Excess of cancer in patients receiving renal transplantation is well-known in Western countries, but information in Japan remains limited. Our study examined whether excess risk is found in patients receiving renal transplantation in Japan. Between 1970 and 1995, 1155 males and 589 females underwent renal transplantation in 6 hospitals, and a total of 12,982 person-years of observation was accumulated. Malignancies developed in 2.6% of patients; O/E ratio was 2.78. Median interval from renal transplantation to tumor development was 58 months. The interval in the patients receiving medication with cyclosporine-A (CyA) (median, 42.5 months) was significantly shorter than that with non-CyA (median, 95.5 months). Median age at the diagnosis of malignancy was 40 years, which is much younger than that in the general population. Relative risk was highest in renal cancer, followed by thyroid cancer, malignant lymphoma and uterine cancer. A distribution of malignancies was different from that reported from Western countries. These findings showed the excess risk of malignancies in Japan with renal transplants, especially in male patients, similar to that observed in Western countries, though the types of malignancy were different.
在西方国家，接受肾移植的患者癌症发病率过高是众所周知的，但日本的相关信息仍然有限。我们的研究调查了日本接受肾移植的患者是否存在过高风险。1970年至1995年间，6家医院的1155名男性和589名女性接受了肾移植，累计观察人年数达12982人年。2.6%的患者发生了恶性肿瘤；观察值与预期值之比为2.78。从肾移植到肿瘤发生的中位间隔时间为58个月。接受环孢素A（CyA）治疗的患者的间隔时间（中位值为42.5个月）明显短于未接受CyA治疗的患者（中位值为95.5个月）。诊断出恶性肿瘤时的中位年龄为40岁，这比普通人群要年轻得多。相对风险在肾癌中最高，其次是甲状腺癌、恶性淋巴瘤和子宫癌。恶性肿瘤的分布与西方国家报告的不同。这些发现表明，日本肾移植患者存在恶性肿瘤过高风险，尤其是男性患者，这与西方国家观察到的情况相似，尽管恶性肿瘤的类型有所不同。
