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背景与目的由于肾移植患者长期应用免疫抑制剂,与普通人群相比更易发生肿瘤。本研究中我们主要分析肾移植患者术后发生肿瘤的临床特点和预后,并评价根治性手术(radicalsurgery,RS)对其预后的影响。方法对本院1987年11月～2004年5月行肾移植手术的2160例患者进行回顾性分析,分析肾移植术后肿瘤的发生时间、肿瘤类型及生存时间等,总结肾移植术后肿瘤的发病特点。按是否行RS将肿瘤患者分为两组,对比研究RS对其预后的影响。结果2160例肾移植手术的患者中33例术后发生肿瘤,以消化系统肿瘤为主(33.3%)。10例行RS治疗(RS组)的患者中位生存时间为41.5个月;23例未行RS治疗(非RS组)者中位生存时间为6.0个月。两组20个月生存率分别为70.0%和13.0%。结论肾移植患者比普通人群更易发生肿瘤,肿瘤类型与普通人群所患不同,以肝癌、皮肤癌、淋巴瘤、甲状腺癌等为主。早期发现、早期治疗,尤其是病情允许行根治性手术者,近期疗效较好,远期效果有待进一步观察。
Background and Objective Since long-term use of immunosuppressive agents in renal transplant recipients, tumors are more likely to occur than in the general population. In this study, we mainly analyzed the clinical features and prognosis of patients with renal allograft after the operation, and evaluated the effect of radical surgery (RS) on the prognosis. Methods A retrospective analysis was performed on 2160 patients undergoing renal transplantation from November 1987 to May 2004 in our hospital. The timing of tumor occurrence, tumor type and survival time after kidney transplantation were analyzed. The changes of tumor after renal transplantation Disease characteristics. According to whether the line RS will be divided into two groups of cancer patients, compared the impact of RS on its prognosis. Results Of the 2160 patients who underwent renal transplantation, 33 had postoperative tumor occurrence, with predominantly digestive system tumors (33.3%). The median survival time in 10 RS patients treated with RS group was 41.5 months. The median survival time was 6.0 months in 23 RS patients without RS. The 20-month survival rates were 70.0% and 13.0% for both groups. Conclusion Kidney transplant patients are more likely to develop tumors than the general population. The tumor types are different from those of the general population. Liver cancer, skin cancer, lymphoma and thyroid cancer are the main factors. Early detection, early treatment, especially the condition allows radical surgery, the recent effect is better, the long-term results need to be further observed.