【摘要】 目的:探讨11例肾移植术后并发恶性肿瘤的发病情况、诊断及治疗结果。方法:回顾性分析11例肾移植术后并发恶性肿瘤患者的临床资料,对肿瘤的发生情况、诊断和治疗情况进行总结。310例患者中有11例(35.5‰)患者发生恶性肿瘤。其中,泌尿系肿瘤7例,淋巴瘤2例,宫颈癌1例,肝癌1例,除1例肝癌外其余10例均经病理确认,泌尿系统肿瘤中单发输尿管癌3例,单发膀胱癌1例,输尿管膀胱癌并发2例,另有1例为多器官性肿瘤,其肾移植术后36个月发生单侧输尿管癌,术后46个月发生单侧肾脏肉瘤样癌,术后60个月再发膀胱癌,并于膀胱癌术后15个月复发,随后出现肝脏转移。11例患者发生肿瘤的时间在肾移植术后6～108个月,平均53.5个月。患者采用以手术为主的治疗,个别配合以放化疗,免疫抑制剂作适当调整。结果:2例淋巴瘤、1例肝癌及1例输尿管并膀胱癌患者1年内死亡,1例多器官性肿瘤术后第8年因肿瘤远处转移而放弃治疗,其余患者随访至今未出现肿瘤复发或转移。结论:肾移植术后恶性肿瘤发生率明显高于普通人,尿路上皮肿瘤较多见,治疗以手术为主并行综合治疗。更多还原

【Abstract】 Objective: To analyze the occurrence, diagnosis and outcomes of 11 cases of malignant tumors following kidney transplantation. Methods: Retrospectively analyzed the clinical datum of 11 cases of malignant tumors following kidney transplantation and summarized the occurrence, diagnosis and therapy. Among 310 cases renal allograft recipients, 11 patients (35.5‰) were diagnosed with malignancies, including 7 cases in urological system, 2 cases were malignant lymphoma, 1 case with cervical cancer, 1 case with hepatic cancer. 10 cases were substantiated by the pathology besides 1 case hepatic cancer. Among the urologic cancers, 3 cases were cancers of ureter singly, 1 case was bladder cancer singly, 2 cases were diagnosed with ureter and bladder cancers, 1 case with multiple organ tumor, which was diagnosed with ureter cancer of one side 36 months after kidney transplantation, with renal sarcomatoid cancer 46 months and with blander cancer 60 months after the transplantation. It relapsed 15 months after the blander operation and had hepatic metastasis subsequently. All of 11 cases were diagnosed at 6-108 months after kidney transplantation. Surgical operation was the main therapy for the patients, some needed radiotherapy and chemotherapy, the immunosuppressant was adjusted aptly. Results: Two cases with lymphoma, 1 case with hepatic cancer and 1 case with ureter and bladder cancers died in 1 year. 1 case with tumors in multiple organ gave up the therapy because of the metastasis 8 months after the transplantation. The rest had no relapse and metastasis up to the present. Conclusion: The incidences of malignancies, especially urological epithelial carcinoma, are high in renal allograft recipients. Operation should be the center of all-around therapy.更多还原