重视肝移植术后新发肿瘤的发生与防治——附单中心5例报告

目的新发肿瘤是肝移植术后常见并发症,是影响肝移植受体晚期死亡的重要原因之一,本文结合5例患者的临床资料和相关关文献对肝移植术后新发肿瘤及其相关危险因素进行阐述。方法回顾性分析5名病例术前相关资料(年龄、性别、原发肝病、嗜烟酒史及癌症家族史)以及术后情况(移植术后免疫抑制治疗方案、急性排斥反应发生与否、新发肿瘤类型、癌症发生时间、癌症治疗及其预后),分析新发肿瘤出现的可能原因。结果 5例肝移植术后新发肿瘤病例(均经病理证实)分别为肺癌、食管癌、淋巴瘤、结肠癌及鼻咽癌,患者均为男性,术后肿瘤诊断的中位年龄为49岁,从接受肝移植手术至肿瘤诊断的时间为17～66月,中位时间44月。结论肝移植术后新发肿瘤常于吸烟、性别以及与肝移植术后患者特有的免疫抑制状态有关,避免过度免疫抑制,特别在于肿瘤高发的移植受体群体,应酌情减量免疫抑制剂的使用,同时加强戒烟忌酒等卫生宣教及术后肿瘤常规监测,以减少其发生率。

Attach great importance to the occurance and prevention of the de novo malignancy after liver transplantation with 5 cases in a single center

Objective In our study we would describe the clinical characteristic of the de novo malignancy after liver transplantation in our centre and analyze the probable cause of the malignancy by comparing with previous research outcome.Methods We retrospectively analyzed the five patients with de novo malignancy after liver transplantation in our centre and the probable risk factors of the de novo malignancy.All patients with a diagnosis of de novo malignancy after transplantation were determined by pathological ...