内分泌恶性瘤:在移植中仍然被忽视的一个问题
Bianca Pellegrini1, Francesca Leone2, Rosita Greco2
1Department of Pharmacy, Health and Nutritional Sciences, University of Calabria, Arcavacata di Rende, Italy.
Frontiers in medicine
|July 2, 2025
概括
移植接受者 (KTRs) 面临内分泌瘤的风险增加,包括甲状腺癌. 需要进一步的研究来了解它们的发展,并指导这些恶性瘤的管理策略.
科学领域:
- 腎臟病學 (nephrology) 是一種醫學專業.
- 在瘤学瘤学.
- 内分泌学 在内分泌学.
背景情况:
- 移植已经取得了进展,但对移植前和移植后阶段的管理仍然对长期的移植生存和并发症具有挑战性.
- 恶性瘤,特别是内分泌瘤,是移植接受者 (KTRs) 显著的免疫抑制相关并发症.
- 关于KTRs内分泌瘤的现有文献是有限的,患病率研究经常将它们与一般人群进行比较.
研究的目的:
- 综合目前关于KTRs内分泌恶性瘤流行病学和病原学的数据.
- 突出需要对这些瘤有更好的理解和管理策略.
- 为了解决临床试验数据有限和移植在内分泌恶性瘤发展中的未定义的致病作用.
主要方法:
- 迷你综述综合了可用的数据和当前的见解.
- 对关于内分泌瘤发病率,发病因子和KTRs治疗的文献分析.
- 识别知识缺口和需要进一步多中心,跨学科研究的领域.
主要成果:
- 甲状腺癌,特别是乳头甲状腺癌,在KTR中发生率很高.
- 罕见的内分泌恶性瘤 (NETs,ACCs,染细胞瘤,副质瘤,甲状腺癌) 主要是在案例研究中报告的.
- 目前还没有临床试验评估免疫抑制治疗对内分泌恶性瘤发病或KTRs发展的影响.
结论:
- 一个多中心的,跨学科的方法对于理解内分泌恶性瘤流行病学和KTRs的发病性至关重要.
- 目前对移植后恶性瘤的指导方针建议减少免疫抑制,但由于数据有限,不建议切换到mTOR抑制剂.
- 对于早期诊断和治疗的具体指导方针是必要的,以便在KTR中安全有效地管理内分泌瘤.
相关概念视频
01:28Kidney Transplant I: Introduction
65
A kidney transplant is a surgical approach that involves replacing a non-functioning kidney with a healthy one from a donor. This procedure is often a treatment option for end-stage renal disease (ESRD) patients. The method requires careful recipient selection, including evaluating various medical and psychosocial factors. These criteria vary between transplant centers but generally include assessments of the patient's overall health, adherence to medical recommendations, and lifestyle...
65
01:26Kidney Transplant II: Surgical Procedure
78
Preoperative ManagementThe primary goals of preoperative management in kidney transplantation are to optimize the patient’s metabolic state and prepare them for surgery through diet adjustments, necessary dialysis, and tailored medical treatment. This phase also involves comprehensive infection screening and patient education about the surgical procedure and postoperative care to improve outcomes and adherence.Medical ManagementA comprehensive evaluation is required for both the living...
78
01:16Kidney Transplant III: Nursing Management
85
Postoperative Nursing Management for Kidney Transplant PatientsPostoperative nursing management care includes monitoring the surgical site, encouraging early movement, and promoting lung health through breathing exercises. Nurses also administer prescribed medications like H2-blockers, such as famotidine, or proton pump inhibitors, like omeprazole, to help prevent gastrointestinal ulcers and bleeding. Fungal infections in the mouth and bladder can result from immunosuppressive and antibiotic...
85
01:22Bone Marrow Sampling and Transplants
506
Bone marrow transplant is a potential cure for several diseases, including cancer and specific genetic disorders. Notably, this procedure is applicable for patients suffering from aplastic anemia, certain types of leukemia, severe combined immunodeficiency disease (SCID), Hodgkin's disease, non-Hodgkin's lymphoma, multiple myeloma, thalassemia, sickle-cell disease, and certain cancers.
The transplant begins with high doses of chemotherapy and radiation treatment, which aim to destroy...
The transplant begins with high doses of chemotherapy and radiation treatment, which aim to destroy...
506
01:25Chronic Kidney Disease I: Introduction
76
Chronic Kidney Disease (CKD) arises when the kidneys progressively lose their ability to function, ultimately leading to end-stage renal disease. At this advanced stage, the kidneys can no longer filter waste or maintain essential body functions, requiring renal replacement therapy (RRT) through dialysis or a kidney transplant for survival.Early-stage chronic kidney disease and detection challengesIn CKD's early stages, symptoms often remain absent because healthy nephrons compensate for...
76
01:24Tissue Transplantation
524
Tissue transplantation is a significant medical procedure involving the transfer of cells, tissues, or organs from a donor to a recipient, with the primary aim of restoring lost functions. This procedure is crucial in treating a broad spectrum of diseases, including kidney diseases, liver failure, heart disease, and certain types of cancers.
The Biology of Tissue Transplantation
The biology of tissue transplantation hinges on the Major Histocompatibility Complex (MHC) molecules. These molecules...
The Biology of Tissue Transplantation
The biology of tissue transplantation hinges on the Major Histocompatibility Complex (MHC) molecules. These molecules...
524