De novo malignancies after liver transplantation: A major cause of late death
De novo malignancies after liver transplantation: A major cause of late death
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DOI：
10.1053/jlts.2001.28645
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发表时间：
2001-11-01
影响因子：
4.6
通讯作者：
Eghtesad, B
中科院分区：
文献类型：
--
作者：
Fung, JJ;Jain, A;Eghtesad, B
1.复发性和原发性恶性肿瘤是肝移植受者晚期死亡的第二大原因，仅次于年龄相关的心血管并发症。与一般人群相比，肝移植受者原发性恶性肿瘤发病率的增加反映了其人口构成、已知的癌症风险因素、慢性病毒感染率的增加以及外源性免疫抑制的作用.原发性恶性肿瘤的发病率最高的是与慢性病毒感染相关的癌症，如EB病毒相关的移植后淋巴组织增生性疾病，以及皮肤癌，包括鳞状细胞癌和卡波西肉瘤。4.虽然口咽恶性肿瘤和结直肠癌等恶性肿瘤的发生率较高，但使用改良的生命表技术和监测流行病学最终结果数据与类似风险组在年龄、性别和随访时间方面匹配的肝移植受者的风险似乎并未增加。然而，他们可能会出现更晚期的疾病。慢性免疫功能低下的肝移植受者新发癌症的发病率增加，需要仔细的长期筛查方案，以帮助在疾病的早期阶段进行诊断。
1. Recurrent and de novo malignancies are the second leading causes of late death in liver transplant recipients, following age-related cardiovascular complications.2. The increased incidence of de novo malignancies in liver transplant recipients compared with the general population reflects their demographic makeup, known preexistent risk factors for cancer, greater rate of chronic viral infection, and actions of exogenous immunosuppression.3. The greatest incidence of de novo malignancies is seen in cancers associated with chronic viral infections, such as Epstein-Barr virus-associated posttransplant lymphoproliferative disease, and skin cancers, including squamous cell carcinoma and Kaposi's sarcoma.4. Although a greater incidence of such malignancies as oropharyngeal malignancy and colorectal cancer was noted, there did not appear to be an increased risk for liver transplant recipients matched for age, sex, and length of follow-up using modified life-table technique and Surveillance Epidemiology End Result data with a similar at-risk group. However, they may present with more advanced stages of disease.5. An increased incidence of de novo cancers in chronically immunocompromised liver transplant recipients demands careful long-term screening protocols to help facilitate diagnosis at an earlier stage of disease.