西罗莫司在肾移植受者新发恶性肿瘤中的应用

发布时间：2018-03-05 18:28

本文选题：西罗莫司　切入点：肾移植　出处：《广东医学》2017年16期 　论文类型：期刊论文

【摘要】：目的总结西罗莫司(SRL)在肾移植术后新发恶性肿瘤患者中的临床应用经验。方法对完成的2 000余例肾移植患者进行随访和统计,共发现在术后新发的恶性肿瘤15例,其中泌尿系统肿瘤6例(40%),呼吸系统肿瘤3例(20%),消化系统肿瘤3例(20%),卡波西肉瘤、子宫内膜癌和黑色素瘤各1例。在明确恶性肿瘤的诊断后,立即进行以SRL为主的免疫抑制方案的调整,并结合肿瘤的生物学特点再辅以手术和放化疗等治疗手段。结果在所有15例新发恶性肿瘤患者的随访中,有10例一直维持较好的生存状态,并且定期复查肾功能情况稳定。而另外5例患者在发现后2~42个月内死亡,但移植肾功能未见明显变化,且死亡患者中以肺癌、肝癌和前列腺癌较多见。结论在肾移植术后新发恶性肿瘤患者中,使用以SRL为主的免疫抑制方案可以取得稳定的肾功能的基础上,同时可控制或缓解恶性肿瘤的进展,但新发肿瘤的生物学特点仍是决定患者生存的主要因素。
[Abstract]:Objective to summarize the clinical experience of sirolimus SRL in patients with new malignant tumor after renal transplantation. There were 6 cases of urinary system tumor, 3 cases of respiratory system tumor, 3 cases of digestive system tumor, 1 case of Kaposi sarcoma, 1 case of endometrial carcinoma and 1 case of melanoma. The immunosuppressive regimen based on SRL was adjusted immediately, combined with the biological characteristics of the tumor, combined with surgery, radiotherapy and chemotherapy, etc. Results all 15 patients with new malignant tumor were followed up. There were 10 patients who had maintained a good living condition and had stable renal function after regular review. The other 5 patients died within 2 ~ 42 months after discovery, but there was no significant change in graft function, and lung cancer was the leading cause of death. Conclusion in the patients with new malignant tumor after renal transplantation, the immunosuppressive regimen based on SRL can achieve stable renal function and control or alleviate the progress of malignant tumor at the same time. However, the biological characteristics of new tumors are still the main factors to determine the survival of patients.
【作者单位】：广州医科大学附属第二医院肾移植科;
【分类号】：R699.2;R730.5

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