在25年时间内，意大利肾移植受者的移植后癌症发生率存在变异。
Variation in Post-Transplant Cancer Incidence among Italian Kidney Transplant Recipients over a 25-Year Period.
发表日期：2023 Feb 20
作者：
Pierluca Piselli, Diego Serraino, Claudia Cimaglia, Lucrezia Furian, Luigi Biancone, Ghil Busnach, Nicola Bossini, Paola Todeschini, Maurizio Iaria, Franco Citterio, Mariarosaria Campise, Massimiliano Veroux, Giuseppe Tisone, Vincenzo Cantaluppi, Margherita Mangino, Simona Simone, Davide Argiolas, Andrea Ambrosini, Francesco Pisani, Flavia Caputo, Martina Taborelli,
来源：
Cancers
摘要：
这项队列研究调查了17个意大利中心的11,418名肾移植受体在25年内的癌症发病率变化。癌症发病率在三个时期（1997-2004年、2005-2012年和2013-2021年）内通过内部（发生率比值-IRR）和外部（标准化发生率比值-SIR）比较进行了调查。泊松回归被用于评估趋势。总体而言，诊断出了1646例移植后的癌症，发病率/1000人年在1997-2004年间的15.5到2013-2021年间的21.0之间有所变化。调整后的IRR显示在剔除非黑色素皮肤癌后所有癌症的发病率在所有时期内均显著减少（IRR = 0.90，95%置信区间-CI: 0.76-1.07在2005-2012年；IRR = 0.72，95% CI: 0.60-0.87在2013-2021年与1997-2004年相比；Ptrend<0.01）。然而，在部位特异性分析中，仅发现对卡波西肉瘤（KS）的发病率有显著变化（IRR = 0.37，95% CI: 0.24-0.57在2005-2012年；IRR = 0.09，95% CI: 0.04-0.18在2013-2021年；Ptrend<0.01）。与一般人口相比，KT受体的移植后癌症风险总体上是升高的，但随着时间的推移而减少（SIR = 2.54，95% CI: 2.26-2.85在1997-2004年；SIR = 1.99，95% CI: 1.83-2.16在2013-2021年；Ptrend<0.01）。特别是对于非何杰金淋巴瘤和KS，SIR的下降被观察到，尽管只有KS趋势在调整后仍保持统计显著性。总之，在意大利KT受体群体中除KS外，并未观察到其他癌症随时间的发生率变化。
This cohort study examined 25-year variations in cancer incidence among 11,418 Italian recipients of kidney transplantation (KT) from 17 Italian centers. Cancer incidence was examined over three periods (1997-2004; 2005-2012; and 2013-2021) by internal (Incidence rate ratio-IRR) and external (standardized incidence ratios-SIR) comparisons. Poisson regression was used to assess trends. Overall, 1646 post-transplant cancers were diagnosed, with incidence rates/1000 person-years ranging from 15.5 in 1997-2004 to 21.0 in 2013-2021. Adjusted IRRs showed a significant reduction in incidence rates across periods for all cancers combined after exclusion of nonmelanoma skin cancers (IRR = 0.90, 95% confidence interval-CI: 0.76-1.07 in 2005-2012; IRR = 0.72, 95% CI: 0.60-0.87 in 2013-2021 vs. 1997-2004; Ptrend < 0.01). In site-specific analyses, however, significant changes in incidence rates were observed only for Kaposi's sarcoma (KS; IRR = 0.37, 95% CI: 0.24-0.57 in 2005-2012; IRR = 0.09, 95% CI: 0.04-0.18 in 2013-2021; Ptrend < 0.01). As compared to the general population, the overall post-transplant cancer risk in KT recipients was elevated, with a decreasing magnitude over time (SIR = 2.54, 95% CI: 2.26-2.85 in 1997-2004; SIR = 1.99, 95% CI: 1.83-2.16 in 2013-2021; Ptrend < 0.01). A decline in SIRs was observed specifically for non-Hodgkin lymphoma and KS, though only the KS trend retained statistical significance after adjustment. In conclusion, apart from KS, no changes in the incidence of other cancers over time were observed among Italian KT recipients.