| 摘要: |
| 目的 了解肝移植术后结直肠恶性肿瘤(新发结直肠癌及肝癌结直肠复发)的发病情况,探讨病因、诊疗及预后情况。方法 收集1996年5月至2011年3月共982例肝移植患者的临床资料,并进行回顾性分析。结果 (1)非肿瘤肝移植患者483例,术后存活1年以上有391例,结直肠发生新发恶性肿瘤3例(发病率为0.76%),其中,2例结肠癌行姑息切除,分别于发病后6个月或3个月死亡,另1例为直肠癌,手术后存活已10个月。(2)肿瘤肝移植患者499例,出现肿瘤复发140例,复发率为28.06%,其中结肠复发3例,占复发的2.14%,均行再次切除术,分别于发病后14、4、7个月死亡;未见直肠复发病例。结论 肝移植术后结直肠恶性肿瘤虽较为少见,但总体预后不佳,需在术前及术后详细排查及尽早处理以改善预后,定期结肠镜检查对于该病的诊断有重要的意义,应列为肝移植术后常规随访项目。 |
| 关键词: 肝移植 新发肿瘤 结直肠肿瘤 肿瘤转移 |
| DOI：10.3724/SP.J.1008.2012.001107 |
| 投稿时间：2012-05-08修订日期：2012-09-11 |
| 基金项目: |
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| Diagnosis and treatment of colorectal cancer after liver transplantation: a report of 6 cases |
| ZHANG Lei△,ZOU You△,TENG Fei,FU Hong,NI Zhi-jia,SHI Xiao-min,GAO Xiao-gang,SONG Shao-hua,GUO Wen-yuan* |
(Department of Organ Transplantation, Changzheng Hospital, Second Military Medical University, Shanghai 200003, China
△Co-first authors.
*Corresponding author.) |
| Abstract: |
| ObjectiveTo investigate the incidence of colorectal cancer (de novo tumor \[DNT\] and neoplasm recurrence in colorectum) in liver transplantation recipients and to discuss its risk factors,diagnosis, treatment and prognosis. MethodsWe retrospectively analyzed the clinical data of 982 patients undergoing liver transplantation from May 1996 to March 2011. Results(1) Among the 483 nontumorous recipients 391 lived for more than one year. Three patients developed DNT (two colon carcinoma and one rectal cancer), with the total incidence rate being 0.76%(3/391)．The two patients with colon carcinoma died 6 and 3 months after operation and the patient with rectal cancer has lived for 10 months after resection. (2) Totally 140 of the 499 tumorous recipients had tumor recurrence after transplantation, with the recurrence rate being 28.06%. Three (2.14%) patient had colon cancer recurrence, and they all received reoperation and died at 14, 4, and 7 months after recurrence. ConclusionThe DNT and neoplasm recurrence in colorectums is not frequent after liver transplantation, but they have a very poor prognosis. Early diagnosis and treatment are the keys to improve the prognosis. Regular coloscopy examination is of great significance for diagnosis and should be done routinely after liver transplantation. |
| Key words: liver transplantation de novo tumors colorectal neoplasms neoplasm metastasis |
