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肾移植术后新发恶性肿瘤:单中心经验

粟大明 邓文锋 刘如敏 李江涛 符芳翔 倪海强 胡杨澄 于立新 徐健 苗芸

粟大明, 邓文锋, 刘如敏, 等. 肾移植术后新发恶性肿瘤:单中心经验[J]. 器官移植, 2020, 11(4): 449-454. doi: 10.3969/j.issn.1674-7445.2020.04.004
引用本文: 粟大明, 邓文锋, 刘如敏, 等. 肾移植术后新发恶性肿瘤:单中心经验[J]. 器官移植, 2020, 11(4): 449-454. doi: 10.3969/j.issn.1674-7445.2020.04.004
Su Daming, Deng Wenfeng, Liu Rumin, et al. De novo malignant tumor after renal transplantation: single-center trial[J]. ORGAN TRANSPLANTATION, 2020, 11(4): 449-454. doi: 10.3969/j.issn.1674-7445.2020.04.004
Citation: Su Daming, Deng Wenfeng, Liu Rumin, et al. De novo malignant tumor after renal transplantation: single-center trial[J]. ORGAN TRANSPLANTATION, 2020, 11(4): 449-454. doi: 10.3969/j.issn.1674-7445.2020.04.004

肾移植术后新发恶性肿瘤:单中心经验

doi: 10.3969/j.issn.1674-7445.2020.04.004
基金项目: 

国家自然科学基金 81500573

广州市民生科技攻关计划项目 20180301010

详细信息
    作者简介:

    粟大明,男,1996年生,硕士研究生,研究方向为肾移植,Email:1309315726@qq.com

    通讯作者:

    苗芸,女,1978年生,博士,主任医师,研究方向为肾移植,Email:miaoyunecho@126.com

  • 中图分类号: R617, R73

De novo malignant tumor after renal transplantation: single-center trial

More Information
  • 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。

     

  • 图  1  肾移植受者的生存曲线图

    Figure  1.  Survival curves of renal transplant recipients

    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%CI,%)
    结直肠 腺癌 9 0.58 21.4(19.7~23.3)
    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)
    腺癌 3 0.20 3.4(2.9~3.9)
    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。
    下载: 导出CSV

    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
    HR(95%CI P HR(95%CI P
    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。
    CI为可信区间。
    下载: 导出CSV
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出版历程
  • 收稿日期:  2020-05-06
  • 网络出版日期:  2021-01-19
  • 刊出日期:  2020-07-15

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