中华器官移植杂志
中華器官移植雜誌
중화기관이식잡지
CHINESE JOURNAL OF ORGAN TRANSPLANTATION
2011年
8期
471-473
,共3页
肾移植%肿瘤%泌尿系统%移植对肿瘤的影响
腎移植%腫瘤%泌尿繫統%移植對腫瘤的影響
신이식%종류%비뇨계통%이식대종류적영향
Kidney transplantation%Neoplasms%Urologic%Graft vs tumor effect
目的 分析肾移植受者泌尿系统恶性肿瘤的发病情况,并探讨其发病机理及治疗方法.方法 回顾性分析1978年至2010年12月间肾移植受者发生泌尿系统恶性肿瘤22例的资料.结果 22例的病理检查结果分别为膀胱移行上皮细胞癌9例(其中1例第3次手术后发现转化为腺癌),膀胱鳞状细胞癌1例,膀胱腺癌1例,肾透明细胞癌3例(其中2例为双侧肾癌),肾低分化癌1例,肾盂移行细胞癌1例,肾盂+膀胱移行细胞癌1例,输尿管移行细胞癌2例,输尿管+膀胱移行细胞癌2例,输尿管移行细胞癌+膀胱腺癌1例.肾癌及输尿管癌均发生在患者原肾及输尿管.11例膀胱癌患者中9例存活,均保有全部或部分肾功能;4例肾癌患者均在发病后半年内死亡;肾盂癌、输尿管癌除2例术后早期死亡外,其余5例存活.22例发现肿瘤后1年存活率为73.7%.结论 肾移植后泌尿系统恶性肿瘤可见少见的病理类型.治疗中应注意免疫抑制剂的使用和移植肾功能保护的问题.肾实质性恶性肿瘤预后很差.
目的 分析腎移植受者泌尿繫統噁性腫瘤的髮病情況,併探討其髮病機理及治療方法.方法 迴顧性分析1978年至2010年12月間腎移植受者髮生泌尿繫統噁性腫瘤22例的資料.結果 22例的病理檢查結果分彆為膀胱移行上皮細胞癌9例(其中1例第3次手術後髮現轉化為腺癌),膀胱鱗狀細胞癌1例,膀胱腺癌1例,腎透明細胞癌3例(其中2例為雙側腎癌),腎低分化癌1例,腎盂移行細胞癌1例,腎盂+膀胱移行細胞癌1例,輸尿管移行細胞癌2例,輸尿管+膀胱移行細胞癌2例,輸尿管移行細胞癌+膀胱腺癌1例.腎癌及輸尿管癌均髮生在患者原腎及輸尿管.11例膀胱癌患者中9例存活,均保有全部或部分腎功能;4例腎癌患者均在髮病後半年內死亡;腎盂癌、輸尿管癌除2例術後早期死亡外,其餘5例存活.22例髮現腫瘤後1年存活率為73.7%.結論 腎移植後泌尿繫統噁性腫瘤可見少見的病理類型.治療中應註意免疫抑製劑的使用和移植腎功能保護的問題.腎實質性噁性腫瘤預後很差.
목적 분석신이식수자비뇨계통악성종류적발병정황,병탐토기발병궤리급치료방법.방법 회고성분석1978년지2010년12월간신이식수자발생비뇨계통악성종류22례적자료.결과 22례적병리검사결과분별위방광이행상피세포암9례(기중1례제3차수술후발현전화위선암),방광린상세포암1례,방광선암1례,신투명세포암3례(기중2례위쌍측신암),신저분화암1례,신우이행세포암1례,신우+방광이행세포암1례,수뇨관이행세포암2례,수뇨관+방광이행세포암2례,수뇨관이행세포암+방광선암1례.신암급수뇨관암균발생재환자원신급수뇨관.11례방광암환자중9례존활,균보유전부혹부분신공능;4례신암환자균재발병후반년내사망;신우암、수뇨관암제2례술후조기사망외,기여5례존활.22례발현종류후1년존활솔위73.7%.결론 신이식후비뇨계통악성종류가견소견적병리류형.치료중응주의면역억제제적사용화이식신공능보호적문제.신실질성악성종류예후흔차.
Objective To investigate the incidence of urological malignancy in renal allograft recipients and explore the mechanism of increased incidence in China and the management. Methods A retrospective study was performed on 22 patients with urological malignancy in renal allograft recipients between 1978 and 2010. Results Twenty-two cases of urological malignancy were diagnosed by pathologic evidence, including 9 cases of transitional cell carcinoma (TCC) of bladder, 1 case of squamous cell carcinoma of bladder, 1 case of adenocarcinoma of bladder, 1 case of TCC of pelvis, 1 case of TCC of bladder and pelvis, 1 case of TCC of ureter complicated with adenocarcinoma of bladder, 2 cases of TCC of ureter, 2 cases of TCC of ureter and bladder, 3 cases of clear cell carcinoma of kidney, and 1 case of undifferentiated carcinoma of kidney. All the malignancies belonged to native organs. All the patients suffering bladder cancer had normal function of allograft. Five patients with TCC of pelvis or ureter survived and 2 cases died early after operation. All the patients suffering renal carcinoma deceased within 6 months after diagnosis. One-year survival rate was 73. 7 % after the diagnosis of urological malignancy. Conclusion Urological malignancy ranked highest in malignancy in renal allograft recipients, and rare pathological types of urological malignancy in non-renal allograft recipients are often demonstrated. The strategy of treatment should take consideration of the relationship between the usage of immunosupressive agents and the preservation of allograft function. It is critical for the therapy of malignancies to possess satisfactory allograft function. The prognosis of renal cell carcinoma is poor.
