肾移植后结直肠癌的危险因素及预防的必要性

Łukasz Kozak, J. Janiszewski, Joanna Wozniak, Martyna Kamrowska, B. Januszko-Giergielewicz
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引用次数: 0

摘要

慢性肾脏疾病患者的肾移植(KT)被认为是肾脏替代治疗的一种方法,可以提供最长和最舒适的生存。肾移植降低了与慢性透析相关的多种并发症的风险,并使该器官移植后的患者充分参与家庭和社会生活。然而,与其他治疗方式一样,肾移植也有其局限性。这些主要与需要慢性免疫抑制治疗有关。研究表明,慢性免疫抑制会增加患癌症的风险。皮肤癌是最常见的免疫抑制相关肿瘤。此外,肾移植后患实体器官癌的风险是普通人群的几倍。癌症是肾移植受者死亡的主要原因之一。这是由于其在该患者群体中的隐匿性和侵袭性病程,以及经常需要修改抗癌治疗。在本文中,我们根据现有文献和我们自己的经验,讨论肾移植后患者结直肠癌(CRC)发病率的增加,疾病病程的差异,以及其潜在的预防措施。根据我们的分析,我们假设需要对所有移植中心统一的严格建议,关于肾移植后患者早期发现结直肠癌的肿瘤监测。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Colorectal cancer after kidney transplantation – risk factors and the need for prevention
Kidney transplantation (KT) in patients with chronic kidney disease is considered a method of renal replacement therapy offering the longest and most comfortable survival possible. Kidney transplantation reduces the risk of multiple complications associated with chronic dialysis, as well as allows patients after transplantation of this organ for full participation in family and social life. However, like any other treatment modality, kidney transplantation has its limitations. These are primarily associated with the need for chronic immunosuppressive therapy. It was shown that chronic immunosuppression increases the risk of cancer. Skin cancers are the most common immunosuppression-related neoplasms. Also, the risk of solid organ cancers is several times higher after kidney transplantation compared to the general population. Cancer is one of the leading causes of mortality in kidney graft recipients. This is due to its insidious and aggressive course in this patient population and the frequent need to modify anticancer therapy. In this paper, we discuss the increased incidence of colorectal cancer (CRC) in patients after kidney transplantation, differences in the course of the disease, as well as its potential prevention, based on the available literature and our own experience. Based on our analysis, we postulate the need for strict recommendations unified for all transplantation centres, regarding oncological surveillance for early detection of colorectal cancer in patients after kidney transplantation.
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