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中华移植杂志(电子版) ›› 2024, Vol. 18 ›› Issue (01) : 35 -39. doi: 10.3877/cma.j.issn.1674-3903.2024.01.007

经验交流

肾移植术后新发泌尿系统恶性肿瘤二例并文献复习
赵丽1, 蔡瑞明2, 赵纪强2, 林民专2, 陈志勇2, 彭娟1,()   
  1. 1. 510150 广州医科大学附属第三医院病理科 广东省产科重大疾病重点实验室 广东省妇产疾病临床医学研究中心 粤港澳母胎医学高校联合实验室
    2. 510150 广州医科大学附属第三医院器官移植科
  • 收稿日期:2023-10-07 出版日期:2024-02-25
  • 通信作者: 彭娟
  • 基金资助:
    广州市科技计划项目(2024A03J0892)

Malignant tumor after renal transplantation: two cases report and literature review

Li Zhao1, Ruiming Cai2, Jiqiang Zhao2, Minzhuan Lin2, Zhiyong Chen2, Juan Peng1,()   

  1. 1. Department of Pathology, Guangdong Provincial Key Laboratory of Major Obstetric Diseases, Guangdong Provincial Clinical Research Center for Obstetrics and Gynecology, Guangdong-Hong Kong-Macao Greater Bay Area Higher Education Joint Laboratory of Maternal-Fetal Medicine, the Third Affiliated Hospital of Guangzhou Medical University, Guangzhou 510150, China
    2. Department of Organ Transplantation, the Third Affiliated Hospital of Guangzhou Medical University, Guangzhou 510150, China
  • Received:2023-10-07 Published:2024-02-25
  • Corresponding author: Juan Peng
引用本文:

赵丽, 蔡瑞明, 赵纪强, 林民专, 陈志勇, 彭娟. 肾移植术后新发泌尿系统恶性肿瘤二例并文献复习[J]. 中华移植杂志(电子版), 2024, 18(01): 35-39.

Li Zhao, Ruiming Cai, Jiqiang Zhao, Minzhuan Lin, Zhiyong Chen, Juan Peng. Malignant tumor after renal transplantation: two cases report and literature review[J]. Chinese Journal of Transplantation(Electronic Edition), 2024, 18(01): 35-39.

随着免疫抑制剂的发展,肿瘤已取代排斥反应等其他肾移植术后并发症成为导致受者术后死亡的主要原因之一[1]。与普通人群相比,实体器官移植受者罹患恶性肿瘤的风险增加2~4倍,且预后更差[2]。许多危险因素与移植后恶性肿瘤发病率升高有关,包括免疫抑制类型、强度和持续时间以及致癌性病毒感染和阳光照射。有数据显示,肾移植术后免疫抑制治疗时间>10年者,其术后恶性肿瘤发生率达20%,超过心血管疾病,成为影响肾移植受者长期存活的重要因素[1,2,3]。本文回顾性分析广州医科大学附属第三医院2例肾移植术后新发泌尿系统恶性肿瘤受者临床资料,并结合文献对近年来肾移植受者术后并发恶性肿瘤的病理特征、临床诊治及预后进行分析,旨在提高诊治水平和改善受者预后,现报道如下。

图1 病例1腹部CT、肿物病理大体和组织病理学检查相关结果注:a.腹部CT扫描结果;b.肿物大体;c.肿瘤组织HE染色结果(× 200); d~i.免疫组织化学检查结果(× 200),依次为PAX2(+)、PAX8(+)、CK7(-)、Vimentin(+)、CD10(+)、P504S(部分+); PAX.配对盒子基因;CK.细胞角蛋白;P504S.α-甲基酰基-辅酶A消旋酶
图2 病例2腹部CT、肿物病理大体、超声和组织病理学检查相关结果注:a.腹部CT检查结果;b.肿物大体;c.肾嫌色细胞癌组织HE染色结果(× 400),箭头示核周空晕及双核细胞;d~i.免疫组织化学结果(× 200),依次为PAX2(+)、PAX8(+)、CK7(+)、Vimentin(-)、CD10(局灶+)、P504S(局灶+); j.甲状腺组织HE染色结果(× 400),绿色箭头示核内假包涵体,黑色箭头示砂砾体;k~l.免疫组织化学结果(× 400),依次为TTF-1胞核强阳性、GAL-3胞浆强阳性;PAX.配对盒子基因;CK.细胞角蛋白;P504S.α-甲基酰基-辅酶A消旋酶;TTF-1.甲状腺转录因子-1; GAL-3.半乳糖凝集素-3
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