肾移植术后恶性肿瘤与HLA抗原频率的研究

目的探讨肾移植术后恶性肿瘤的发生与人类白细胞抗原（HLA）抗原频率的关系。方法对具有HLA分型的肾移植术后发生恶性肿瘤的107例患者进行HLA抗原频率分析。107例肾移植术后肿瘤患者分为4组，肾盂输尿管癌组，42例；膀胱肿瘤组，19例；其他泌尿系肿瘤组，14例；其他非泌尿系肿瘤组，32例。肾移植术后未发生恶性肿瘤的肾移植患者作为正常对照组，共计1131例。结果在107例肾移植术后发生恶性肿瘤患者中，泌尿系统肿瘤75例，占肾移植术后发生恶性肿瘤患者的70.09%（75/107）。肾盂输尿管恶性肿瘤组HLA-A30、其他泌尿恶性肿瘤组的HLA-A32抗原频率与肾移植术后未发生恶性肿瘤的肾移植患者比较，差异有统计学意义（P均〈0.05）。其他泌尿系肿瘤组中 HLA-B62与肾移植术后未发生恶性肿瘤的肾移植患者比较，差异有统计学意义（P〈0.05）。在HLA- DR 抗原频率中，未发现与 HLA 相关的 HLA-DR 抗原，HLA-DR1在膀胱癌和其他泌尿癌中均未出现， HLA-DR17、DR10在肾盂癌和其他泌尿系癌中均未出现。在HLA-DQ抗原频率中，膀胱癌组HLA-DQ9的抗原频率与未发生恶性肿瘤的肾移植患者比较，差异有统计学意义（P〈0.05）。结论某些HLA抗原与肾移植术后患者发生恶性肿瘤具有一定的关联。

A study on the relation between HLA antigen frequency and post-transplant malignant tumor

Objective To study the relation between HLA antigen frequency and post-transplant malignant tumor. Methods HLA antigen frequency was analyzed in 107 post-transplant malignant tumor patients who had HLA typing tested. 107 patients were classified into four groups： the first group was composed of 42 patients with renal pelvic and ureteral carcinoma; the second group consisted of 19 of bladder tumor patients; the third group was composed of 14 pa-tients with other urinary tumorss; the last group were patients with other tumors. 1 131 post-transplant patients with-out malignant tumor were used as the control group. Transplant surgical operations were done during Jan, 1998 to Dec, 2004. Results In the 105 post-transplant malignant tumor patients, 73 （70.09%（75/107）） tumors were located in the urinary tract. In the renal pelvic and ureteral carcinoma group and other urinary tumor group, the relation between HLA-30 and HLA-32 frequency and post-transplant non-tumor patients was statistically significant （P＆lt;0.05和P＆lt;0.05）. In pa-tients with other urinary tumors, the relation between HLA-B62 frequency and post-transplant non-tumor patients was sta-tistically significant （P＆lt; 0.05）. No HLA-DR antigen was detected, however, both DR1 and DR17 antigen were not de-tected in bladder cancer and other urinary cancers. DR10 was not detected in patients with pelvis cancer and other urinary cancer. In the bladder tumor group, the relation between HLA-DQ9 antigen frequency and post-transplant non-tumor pa-tients was statistically significant （P ＆lt; 0.05）. Conclusion This study suggests that some HLA antigen is related to post-transplant malignant tumor.