固体器官移植接受者与移植前癌症史的癌症风险
Jun Tao1, Ruth M Pfeiffer1, Shyfuddin Ahmed1
1Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Bethesda, Maryland.
JAMA oncology
|March 12, 2026
概括
经过癌症诊断的固体器官移植接受者面临更高的风险发展后续癌症,特别是相同类型的癌症. 这凸显了针对这一群体进行查和预防癌症的必要性.
科学领域:
- 在瘤学瘤学.
- 移植医学 移植医学 移植医学
- 流行病学 流行病学
背景情况:
- 癌症幸存者患后续癌症的风险增加.
- 固体器官移植 (SOT) 接受者患癌症的风险更高.
- 在有癌症史的SOT接受者中,随后的癌症风险尚不清楚.
研究的目的:
- 在SOT接受者中调查移植前癌症和移植后癌症风险之间的关联.
- 为了比较SOT接受者与没有癌症史的移植后癌症风险.
- 评估移植前癌症模式是否预测移植后癌症的发展.
主要方法:
- 一项队列研究,利用美国移植受体科学注册表和34个基于人口的癌症注册表 (1995-2019) 的链接数据.
- 包括520,424名SOT受益者.
- 分析了581种移植前和移植后癌症组合,使用因年龄,性别和移植器官而调整的发病率比率 (IRR).
主要成果:
- 移植前癌症的SOT接受者患有移植后癌症的风险增加 (IRR > 1.0).
- 七种移植前的癌症与移植后的相同癌症类型有显著的关联,包括乳腺,黑色素瘤,肺,脏,膀,肝脏和结肠直肠.
- 确定了特定的癌症序列,例如肝脏,其次是肺癌或前列腺癌.
- 肝脏肝脏,脏脏和肺肺移植后癌症的IRR低于一般人口标准化发病率 (SIR).
结论:
- 移植前癌症显著增加了SOT接受者的移植后癌症的风险,特别是在相同的癌症类型中.
- 共同的遗传或环境因素可能有助于这些关联.
- 末期器官疾病可能在特定的器官癌症序列 (例如脏,肝脏,肺部) 中发挥作用.
- 针对性癌症预防和查对于有癌症史的SOT接受者至关重要.
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