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摘要:
目的 分析肾移植受者新发恶性肿瘤的发病情况和危险因素。 方法 回顾性分析接受肾移植术的1 549例受者的临床资料,包括肾移植受者术后新发恶性肿瘤的基本情况、病理类型及发生率;分析肾移植术后新发恶性肿瘤受者的生存情况;分析肾移植术后新发恶性肿瘤的影响因素。 结果 肾移植受者中恶性肿瘤发生率为3.03%(47/1 549)。47例受者移植时年龄为(48±12)岁,诊断出肿瘤时的年龄为(55±12)岁,移植至确诊恶性肿瘤的时间为66(36,100)个月。新发恶性肿瘤中,结直肠癌最常见,累积发生率(CIR)为0.58%。47例肾移植术后新发恶性肿瘤受者的生存时间为59(2,135)个月,其5年生存率为50%。受者移植时年龄 > 45岁是肾移植术后新发恶性肿瘤的危险因素(P < 0.05)。 结论 肾移植受者的新发恶性肿瘤发生率较高,受者移植时年龄 > 45岁是肾移植受者新发恶性肿瘤的危险因素。 Abstract:Objective To analyze the incidence and risk factors of de novo malignant tumors in renal transplant recipients. Methods Clinical data of 1 549 renal transplant recipients were retrospectively analyzed, including the basic status, pathological type and incidence rate of patients with de novo malignant tumors after renal transplantation. The survival situation of these patiensts was assessed. And the risk factors of de novo malignant tumors after renal transplantation were identified. Results The incidence rate of de novo malignant tumors in renal transplant recipients was 3.03%(47/1 549). The 47 recipients were (48±12) years old when undergoing renal transplantation, and they were (55±12) years old when diagnosed malignant tumors. The time interval between transplantation and diagnosis was 66 (36, 100) months. Among the de novo malignant tumors, colorectal cancer was the most common, with a cumulative incidence rate (CIR) of 0.58%. The survival time of 47 recipients with de novo malignant tumors after renal transplantation was 59 (2, 135) months, and the 5-year survival rate was 50%. The recipients with the age > 45 years old when undergoing renal transplantation was a risk factor for de novo malignant tumors after renal transplantation (P < 0.05). Conclusions The incidence rate of de novo malignant tumors is relatively high in renal transplant recipients. The recipients with the age > 45 years old when undergoing renal transplantation is a risk factor for de novo malignant tumors. -
Key words:
- Renal transplantation /
- Malignant tumor /
- Cumulative incidence rate /
- Risk factor /
- Colorectal cancer /
- Survival rate
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表 1 不同部位恶性肿瘤的病理类型及发生率
Table 1. The pathological type and incidence rate of malignancy in different sites
肿瘤部位 病理类型 n CIR(%) SIR(95%CI①,%) 结直肠 腺癌 9 0.58 21.4(19.7~23.3) 肝 肝细胞癌 5 0.32 12.1(10.8~13.5) PTLD 弥漫性大B细胞淋巴瘤结外黏膜相关淋巴瘤 5 0.32 54.3(48.6~60.6) 肾脏 尿路上皮癌透明细胞癌 5 0.32 64.7(57.8~74.1) 膀胱 尿路上皮癌小细胞癌 4 0.25 45.2(39.9~51.1) 宫颈 鳞癌 3 0.20 25.0(22.4~29.9) 肺 腺癌 3 0.20 3.4(2.9~3.9) 胃 腺癌印戒细胞癌 2 0.13 4.0(3.6~5.1) 乳腺 黏液腺癌 2 0.13 3.1(2.6~3.7) 前列腺 滤泡腺癌 2 0.13 25.8(21.5~30.6) 其他 7 0.45 总计 47 3.03 11.0(10.5~11.3) 注:①CI为可信区间。 表 2 肾移植术后新发恶性肿瘤的危险因素分析
Table 2. Risk factors analysis for de novo malignant tumors after renal transplantation
变量 单因素分析 多因素分析 HR①(95%CI②) P值 HR(95%CI) P值 性别 0.62(0.34~1.11) 0.107 0.658(0.363~1.191) 0.167 移植时年龄 > 45岁 2.29(1.24~4.22) 0.007 0.966(0.943~0.990) 0.005 肿瘤家族史 2.37(0.71~7.94) 0.108 1.826(0.522~6.389) 0.346 发生急性排斥反应 2.07(0.86~5.00) 0.090 1.928(0.756~4.914) 0.169 发生DGF 1.24(0.48~3.18) 0.660 0.956(0.351~2.599) 0.930 注:①HR为风险比。
②CI为可信区间。 -
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