肾移植术后恶性肿瘤患者群体反应性抗体和肾功能的研究

目的研究肾移植术后发生恶性肿瘤患者的群体反应性抗体(PRA)和肾功能情况。方法研究对象为可追踪到具有PRA结果的63例肾移植术后发生恶性肿瘤的患者。于2012年10月采用美国GTI公司提供的ELISA筛选HLA-Ⅰ类、Ⅱ类混合抗原板,检测肾移植术后PRA。肾移植术后未发生恶性肿瘤的肾移植患者为正常对照组,共计902例。肾移植患者移植手术时间最早在1995年11月,最迟移植患者手术时间为2008年3月。结果 63例肾移植术后发生恶性肿瘤的患者中,PRA阳性患者11例,占17.46%(11/63),移植肾功能下降患者5例,占45.45%(5/11)。902例正常对照组的肾移植患者中,PRA阳性患者94例,占10.42%(94/902),移植肾功能下降患者83例,占88.30%(83/94)。肾移植术后正常患者与肾移植术后发生恶性肿瘤患者肾移植术后产生PRA之间无统计学差异(χ2=2.33,P0.25)。结论虽然免疫抑制剂可抑制移植肾的排斥反应,但在肾移植术后发生恶性肿瘤和正常患者间产生PRA的几率无显著差异。

A study of panel reactive antibody and renal function in post -transplant patients with malignant tumor

Objective To study the relation between panel reactive antibody（ PRA）and post-transplant malignant tumor. Methods Sixty-three post-transplant malignant tumor patients were available for the detection of the HLA-I Class and II Class antibodies in Oct. 2012. （ GTI Diagnostics kits of USA）. Nine hundred and two patients who didn＇t experience malignant tumor after transplantation were classified into con-trol group. The earliest transplantation finished in Nov. 1995,the latest in Mar. 2008. Results In the 63 post-transplant malignant tumor pa-tients,11 patients（17. 46%）showed PRA positive;and renal function decreased in 5 of 11 PRA positive patients（45. 45%）. In the 902 pa-tients of control group,94 patients（10. 42%）showed PRA positive;and renal function decreased in 83 of 94（88. 30%）PRA positive patients. There was no statistical significance in PRA production between patients with or without post-transplant malignant tumor（χ2 =2. 33,P 〉0. 25）. Conclusion Although immunosuppressive agent can inhibit transplant rejection,there is no statistical significance in PRA production be-tween patients with or without post-transplant malignant tumor.