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移植脏之前和之后的癌症发生率
Claire M Vajdic1, Stephen P McDonald, Margaret R E McCredie
1National Centre in HIV Epidemiology and Clinical Research, University of New South Wales, Sydney, Australia. cvajdic@nchecr.unsw.edu.au
JAMA
|December 21, 2006
概括
移植在许多部位显著增加癌症风险,主要是由于免疫抑制. 这突显了免疫力,病毒和癌症发展之间的相互作用.
科学领域:
- 腎臟病學 (nephrology) 是一種醫學專業.
- 在瘤学瘤学.
- 免疫学 免疫学 免疫学
背景情况:
- 器官移植需要免疫抑制,增加某些癌症的风险,如非黑色素瘤皮肤癌.
- 之前对移植后长期癌症发病率的研究是有限的.
研究的目的:
- 为了比较移植患者的癌症发病率与他们的移植前时期 (透析和无置换治疗的末期病).
主要方法:
- 基于人口的队列研究,包括28855名末期病患者.
- 对273,407人年进行了跟踪,从1982年至2003年确定了癌症发病率.
- 使用标准化发病率比率 (SIRs) 与一般人口的发病率相比.
主要成果:
- 移植后癌症发病率明显增加 (SIR 3.27),而透析期间 (SIR 1.35) 和脏替代疗法之前 (SIR 1.16) 的癌症发病率略有增加.
- 在移植后的25个部位观察到显著增加的癌症发病率,在18个部位的风险超过3倍.
- 大多数移植后的癌症都是已知的或疑似的病毒病因.
结论:
- 腎臟移植與許多部位的癌症風險大幅增加有關.
- 移植后的免疫抑制可能是癌症风险增加的原因.
- 表明免疫系统与病毒感染相互作用在癌症发展中的作用更广泛.
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