肾移植受者的肺癌

Mirela Jozičić, Alen Imširović, L. Katalinic, B. Krtalic, N. Jukić
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摘要

摘要介绍。尽管实体器官移植后恶性肿瘤的发生率有所增加,但这类患者中肺癌的数据很少。本研究的目的是确定肾移植后发生肺癌患者的临床特征和预后。方法。在1973年至2014年期间,在我院接受移植手术的1658名患者中,有5名患者患上了肺癌。我们分析了危险因素、移植特点、治疗方案和生存率。结果。肺癌5例(0.3%)。移植手术后诊断时间从26到156个月不等(平均115个月)。他们都有吸烟史。肿瘤分为IIB(20%)、IIIA(40%)和IV(40%)。组织学类型包括腺癌(80%)和肉瘤样癌1例(20%)。1例合并甲状腺乳头状癌。放疗2例,化疗2例(厄洛替尼联合卡铂和依托泊齐各1例),2例诊断为播散性恶性疾病后1个月内死亡。IIIA期患者在诊断后分别存活了14个月和24个月。该肉瘤样癌患者接受了完全切除的开胸手术,失去了移植功能,在诊断后7个月死亡。结论。肺癌是肾移植受者中相对罕见的恶性肿瘤,但与高死亡率相关。吸烟是重要的危险因素,因此应在肾移植受者中提倡戒烟,并定期进行肺癌筛查。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Lung Cancer in Renal Transplant Recipients
Abstract Introduction. Although the incidence of malignancy has increased after solid organ transplantation, data on lung cancer in this group of patients is scarce. The aim of this study was to determine clinical characteristics and outcome of patients who developed lung cancer after renal transplantation. Methods. Among a cohort of 1658 patients who received a transplant at our institution and were followedup between 1973 and 2014, five patients developed lung cancer. We analyzed risk factors, transplantation characteristics, treatment options and survival. Results. Lung cancer was diagnosed in 5 patients (0.3%). Time to diagnosis after the transplant procedure ranged from 26 to 156 months (mean 115 months). All of them had a smoking history. Tumors were classified as IIB (20%), IIIA (40%), and IV (40%). Histological types included adenocarcinoma (80%) and there was one case of sarcomatoid carcinoma (20%). One patient had concomitant thyroid papillary carcinoma. Radiotherapy was applied in 2 patients, 2 underwent chemotherapy (erlotinib and combination of carboplatinum and etopozide in one patient each), and 2 died within one month after the diagnosis from disseminated malignant disease. Patients with stage IIIA survived 14 and 24 months after the diagnosis. The patient with sarcomatoid cancer underwent thoracotomy with a complete resection, lost his graft function and died 7 months after the diagnosis. Conclusion. Lung cancer is relatively rare malignancy in renal transplant recipients, but associated with high mortality. Smoking is a significant risk factor, thus smoking cessation should be promoted among renal transplant recipients, as well as regular screening for lung cancer.
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