肝移植术后新发食管癌1例临床分析并文献复习

目的探讨肝移植术后新发食管癌的发病情况、危险因素、预防及治疗。方法对2003年8月至2008年12月中山大学附属第三医院肝移植中心行肝移植术后生存半年以上并能接受定期随访的416例受者，观察其新发恶性肿瘤的情况，分析新发食管癌患者的临床资料，同时进行文献复习。结果该中心肝移植术后新发食管癌1例，发生率为0．24％（国外平均发生率为0．11％）。该例男性患者肝移植时年龄为49岁，术前有长期吸烟史和嗜酒史，术后不完全戒酒、戒烟，术后46个月发现食管癌，从确诊新发食管癌至死亡历时10个月，死于肿瘤进展、多器官功能衰竭。结论烟酒史、免疫抑制过强是肝移植术后新发恶性肿瘤的危险因素，针对高危因素进行规范随诊以及优化免疫抑制方案，是早期防治和提高疗效的关键。

De novo esophagus cancer following liver transplantation: case report and literature review

Objective To analyze the clinical characteristics, risk factors, prevention and treatments of de novo esophagus cancer following orthotopic liver transplantation （OLT）. Methods Clinicopathological data of patients with de novo esophagus cancer out of 416 patients （0.24%） who underwent OLT from August 2003 to December 2008 were analyzed. Results The morbidity of de novo esophagus cancer after OLT in our institution was 0.24% （1/416） , and foreign data displayed that the average rate was 0. 11%. The age of the patient （ male ） with OLT history was 49 years old. The diagnosis of tumor was made in 46 months after OLT. The patient survived for 10 months before dying of tumor progression and multiple organ failure. Conclusion Smoking, drinking, and over- immunosuppression were associated with a higher risk of malignancy. Screening protocols might benefit natients bv nroviding a diagnosis at an earlier sta~e when tumors mav be cured.