肾移植术后尿路上皮癌发病特点的文献统计分析(1)

http://www.100md.com 2018年4月2日 《医学信息》 2018年第13期

     摘 要：目的 统计分析国内肾移植尿路上皮癌患者的发病率、发病特点，提高临床工作中对此类疾病的认识。方法 检索目前从2005～2017年的国内权威中文数据库中国知网全文数据库和万方全文数据库，分别按照发病率、发病年龄、性别、发病部位、发病时间、马兜铃酸肾病的影响等方面收集统计数据，分析其临床意义。结果 文献统计肾移植术后尿路上皮癌的发病率约1.17～2.27%，高于普通人群中的发病率；发病年龄45～56岁；女性发病率64.93%，高于男性35.07%，差异有统计学意义(P<0.05)；原上尿路发病率50.81%，高于膀胱49.19%，，移植肾同侧发病率70.80%，高于对侧为29.20%，差异无统计学意义(P>0.05)；发病时间的分布主要在肾移植术后1～16.8个月内；相应文献报道马兜铃酸肾病是肾移植术后尿路上皮癌发病和复发的危险因素。结论 具有马兜铃酸肾病病史的女性患者是肾移植术后尿路上皮癌发生的高危人群，对高危患者的诊断和治疗应该更加重视，改进治疗方案，做到早发现早治疗。

    关键词：肾移植，尿路上皮癌，文献统计分析

    中图分类号：R737.1 文献标识码：A DOI：10.3969/j.issn.1006-1959.2018.13.036

    文章编号：1006-1959(2018)13-0123-05

    Abstract：Objective To analyze the incidence and characteristics of urothelial carcinoma in patients with renal transplantation and to improve the understanding of such diseases in clinical work.Methods This paper retrieves the full text database of Chinese knowledge network and the full text database of Chinese authoritative Chinese database from 2005～2017，and collect statistical data according to the incidence，age，sex，location，time of onset，the influence of aristolochic acid nephropathy and so on，and analyze its clinical significance.Results The incidence of urothelial carcinoma after renal transplantation is about 1.17～2.27%，which is higher than that in the general population；the age of onset is 45～56 years old；the incidence rate of female is 64.93%，which is higher than that of male 35.07%，the difference was statistically significant(P<0.05)；the incidence of the original upper urinary tract was 50.81%， which was higher than that of the bladder 49.19%，and the incidence rate of ipsilateral transplantation was 70.80%，which was higher than that of the contralateral side 29.20%，the difference was not statistically significant(P>0.05)；the distribution of onset time was mainly within 1～16.8 months after renal transplantation；the corresponding literature reported that aristolochic acid nephropathy is a risk factor for the onset and recurrence of urothelial carcinoma after renal transplantation.Conclusion Female patients with a history of aristolochic acid nephropathy are at high risk of urothelial carcinoma after renal transplantation.The diagnosis and treatment of high-risk patients should be paid more attention to，and the treatment plan should be improved to achieve early detection and early treatment.

    Key words：Renal transplantation；Urothelial carcinoma；Literature and statistical analysis

    由于腎移植手术技术的改良、新型免疫抑制剂的问世、二次乃至三次移植的展开，供体肾脏的生存率以及患者的存活率都得到了大幅的提高，进而导致接受移植患者的平均年龄也在逐年上升，而与此同时提升的还有移植术后肿瘤的发生率。在我国以尿路上皮肿瘤的发生最为明显，据统计约占肾移植术后肿瘤的47%[1]，但目前我们对此类疾病的发病特点和相关因素尚没有一个清楚的认识。我们可以在相关的文献报道中观察到一些流行病学、发病特点及风险因素的共性。为探究肾移植术后尿路上皮癌观察特点中哪些有统计学意义，能否作为临床经验指导临床工作，笔者通过收集文献进行统计性分析的方式对其逐个进行检验，以求从发病率、临床特点及危险因素等方面总结更为确切的规律。(王畅 祝清国)

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