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固体臓器移植を受けた米国人の癌リスクのスペクトル
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
まとめ
固体臓器移植受容者は,がんのリスクが2倍になり,非ホジキンリンパ腫,肺,肝臓,腎臓がんを含む32種類の悪性腫瘍の発生率が上昇します. これは,移植集団におけるがんの継続的な監視の必要性を強調しています.
科学分野:
- 移植免疫学 移植免疫学
- 腫瘍学 腫瘍学
- エピデミオロジー エピデミオロジー
背景:
- 固体臓器移植受容者は,免疫抑制と腫瘍性ウイルス感染症により,がんのリスクが高くなります.
- 以前の研究は主に腎臓受容者に焦点を当てており,異なる臓器移植タイプに関するより広範な研究が必要でした.
研究 の 目的:
- 固体臓器移植後のがん発生率の全体的なパターンを包括的に記述する.
- 移植受容者における高リスクの特定の悪性腫瘍を特定する.
主な方法:
- 移植受給者の米国科学登録 (1987-2008) と13の州/地域がん登録からリンクされたデータを利用したコホート研究.
- 標準化発生率 (SIR) と過剰絶対リスク (EAR) を計算して,移植受容者のがんリスクを一般の人々と比較した.
主要な成果:
- この研究では,175,732件の固体臓器移植 (腎臓,肝臓,心臓,肺) を分析した.
- 全体的ながんリスクは高かった (SIR,2.10),32種類の悪性腫瘍のリスクが増加し,その中にはノンホッジキンリンパ腫,肺,肝臓,腎臓のがんも含まれていた.
- 特定のリスクは臓器の種類によって異なるが,肺受容者の肺がんと肝臓受容者の肝臓がんの有意な増加がある.
結論:
- 固体臓器移植受容者は,一般の人々と比較して,感染に関連するおよび関連のないさまざまながんのリスクが高くなります.
- 発見は,移植受容者に合わせた癌の監視と予防戦略の重要性を強調しています.
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