背景:实体器官移植后恶性肿瘤的发病率高于正常人群。我们研究的目的是确定肝脏后肾细胞癌(RCC)的风险,肾,心肺移植,分别,并建议移植患者可以早期筛查肿瘤以避免风险。
方法:PubMed,Embase和Cochrane图书馆从成立到2023年8月16日。纳入并提取了回顾性和队列研究,重点是实体器官移植(SOT)一年以上的RCC标准化发生率(SIR)的统计数据。这项研究在PROSPERO注册,CRD4202022343633。
结果:已纳入16项原始研究进行荟萃分析。肝移植可增加RCC的风险(SIR=0.73,95CI:0.53~0.93),无异质性(P=0.594,I2=0.0%)。肾移植可增加肾癌的风险(8.54,6.68至10.40;0.000,90.0%)。此外,心肺移植也可能增加RCC的风险(SIR=0.73,95CI:0.53~0.93;SIR=1.61,95CI:0.50~2.71).此外,在大多数亚组中也可以找到意义,尤其是欧洲组和回顾性研究组。更重要的是,在删除对肾移植后RCC率的总体结果影响较大的研究后,异质性没有解决,在欧洲组中也观察到显著差异(7.15,5.49~8.81;0.000,78.6%).
结论:肝脏,肾,与普通人群和大多数亚组相比,心肺移植患者处理RCC的风险增加,特别是在欧洲分组的地理位置,这表明移植后患者应经常进行筛查。
BACKGROUND: The incidence rate of malignant tumors after solid organ transplantation is higher than the normal population. The aim of our study is to identify the risk of renal cell carcinoma (RCC) after liver, kidney, heart and lung transplantation, respectively, and suggest that transplant patients can be screened early for tumors to avoid risk.
METHODS: PubMed, Embase and the Cochrane Library from their inception until August 16,2023. Retrospective and cohort studies which focus on the statistical data of standardized incidence ratios (SIRs) of RCC after solid organ transplantation (SOT) more than one year have been included and extracted. The study was registered with PROSPERO, CRD4202022343633.
RESULTS: Sixteen original studies have been included for meta-analysis. Liver transplantation could increase the risk of RCC (SIR = 0.73, 95%CI: 0.53 to 0.93) with no heterogeneity(P = 0.594, I2 = 0.0%). And kidney transplantation could increase the risk of RCC(8.54, 6.68 to 10.40; 0.000,90.0%). Besides, heart and lung transplantation also could increase the risk of RCC(SIR = 0.73, 95%CI: 0.53 to 0.93; SIR = 1.61, 95%CI:0.50 to 2.71). Moreover, significance could also be found in most subgroups, especially the European group and retrospective study group. What\'s more, after removing studies which have a greater impact on the overall outcome in RCC rate after kidney transplantation, heterogeneity did not solve and significant different was also observed in the European group (7.15, 5.49 to 8.81; 0.000, 78.6%).
CONCLUSIONS: Liver, kidney, heart and lung transplantation patients have an increased risk of processing RCC compared to the general population and most subgroups, especially in geographic location of European subgroup, which suggested that patients should be screened frequently after transplantation.