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Espectro de riesgo de cáncer entre los receptores estadounidenses de trasplante de órganos sólidos
Eric A Engels1, Ruth M Pfeiffer, Joseph F Fraumeni
1National Cancer Institute, 6120 Executive Blvd, EPS 7076, Rockville, MD 20892, USA. engelse@exchange.nih.gov
JAMA
|November 3, 2011
Resumen
Los receptores de trasplantes de órganos sólidos se enfrentan a un riesgo de cáncer duplicado, con mayores tasas de 32 tumores malignos, incluido el linfoma no Hodgkin y los cánceres de pulmón, hígado y riñón. Esto pone de relieve la necesidad de una vigilancia continua del cáncer en las poblaciones de trasplantes.
Área de la Ciencia:
- Inmunología del trasplante Inmunología del trasplante.
- Oncología Oncología.
- Epidemiología La epidemiología.
Sus antecedentes:
- Los receptores de trasplantes de órganos sólidos tienen un mayor riesgo de cáncer debido a la inmunosupresión y las infecciones virales oncogénicas.
- Los estudios anteriores se centraron principalmente en los receptores de riñón, lo que requirió una investigación más amplia en diferentes tipos de trasplante de órganos.
Objetivo del estudio:
- Describir exhaustivamente el patrón general de la incidencia del cáncer después del trasplante de órganos sólidos.
- Para identificar tumores malignos específicos con un riesgo elevado en los receptores de trasplantes.
Principales métodos:
- Un estudio de cohorte que utiliza datos vinculados del Registro Científico de Recipientes de Trasplantes de los Estados Unidos (1987-2008) y 13 registros estatales / regionales de cáncer.
- Se calcularon los ratios de incidencia estandarizados (SIR) y el exceso de riesgos absolutos (EAR) para comparar el riesgo de cáncer en los receptores de trasplantes con la población general.
Principales resultados:
- El estudio analizó 175.732 trasplantes de órganos sólidos (riñón, hígado, corazón, pulmón).
- El riesgo general de cáncer fue elevado (SIR, 2.10), con un mayor riesgo de 32 tumores malignos, incluido el linfoma no Hodgkin, cáncer de pulmón, hígado y riñón.
- Los riesgos específicos variaron según el tipo de órgano, con aumentos notables en el cáncer de pulmón para los receptores de pulmón y el cáncer de hígado para los receptores de hígado.
Conclusiones:
- Los receptores de trasplantes de órganos sólidos exhiben un mayor riesgo de una amplia gama de cánceres relacionados con infecciones y no relacionados en comparación con la población general.
- Los hallazgos subrayan la importancia de las estrategias de vigilancia y prevención del cáncer adaptadas a los receptores de trasplantes.
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