肾移植后膀胱恶性肿瘤4例并文献复习

背景：肾移植后受者的人/肾存活率得到了显著提高，但免疫抑制剂的长期使用增加了肾移植后受者发生恶性肿瘤的风险。 目的：结合文献对肾移植后膀胱恶性肿瘤4例患者进行回顾性病例分析。 方法：复旦大学附属中山医院泌尿外科2007-03/2008-02共收治肾移植后膀胱恶性肿瘤患者4例，肾移植后均予以环孢素A为主的三联免疫抑制治疗方案，其中3例为女性，首次诊断膀胱肿瘤的平均年龄为52.3岁，距肾移植的平均时间为7.3年，结合文献对其进行回顾性病例分析。 结果与结论：肾移植后膀胱恶性肿瘤的发生相对少见，但由于其进展快、易复发和转移、恶性程度较高，应引起临床医师的警惕。对肾移植受者要加强移植后随访观察，移植后每年应进行至少1次的泌尿系统超声影像学等检查，对出现肉眼血尿或镜下血尿的患者更要高度重视，争取肾移植后膀胱肿瘤的早期诊断和积极治疗对于提高肾移植受者长期生存率有积极意义。

Bladder malignancies following renal transplantation in 4 cases: Literature review

BACKGROUND: The people/renal survival rates have been improved greatly after renal transplantation, however, the long-term utilization of immunosuppressant enlarge the risk of malignancies. OBJECTIVE: Combined with literatures to retrospective analyze the bladder malignancies following renal transplantation in 4 cases. METHODS: Totally 4 cases with bladder malignancies following renal transplantation at the Department of Urinary Surgery, Zhongshan Hospital, Fudan University, from March 2007 to February 2008 were selected. All of them received triple immunosuppressive therapy after renal transplantation, including 3 females; mean aged 52.3 years when first diagnosed as bladder tumor, which was 7.3 years after renal transplantation. The cases were retrospective analyzed combined with literatures. RESULTS AND CONCLUSION: Though bladder malignancy was rare following renal transplantation, it was still aroused increasing attention due to fast progression, easy recurrence and high malignancy. Follow-up for transplantation patients are necessary, ultrasonographic image examination should be performed once yearly, especially for those who appeared gross hematuria or microscopic hematuria. Early diagnosis and active treatment for bladder malignancy play an important role in the long-term survival of patients received renal transplantation.