Kidney transplant patients have a higher risk of renal cell carcinoma (RCC) compared to non-transplanted end-stage kidney disease (ESKD) patients. This increased risk has largely been associated with the use of immunosuppression; however, recent genetic research highlights the significance of tissue specificity in cancer driver genes. The implication of tissue specificity becomes more obscure when addressing transplant patients, as two distinct metabolic environments are present within one individual. The oncogenic potential of donor renal tissue is largely unknown but assumed to pose minimal risk to the kidney transplant recipient (KTR). Our review challenges this notion by examining how donor and recipient microenvironments impact a transplant recipient’s associated risk of renal cell carcinoma. In doing so, we attempt to encapsulate how ESKD-RCC and KTR-RCC differ in their incidence, pathogenesis, outcome, and approach to management.
相较于非移植的终末期肾病患者，肾移植患者罹患肾细胞癌的风险更高。这种风险增加主要与免疫抑制剂的使用有关；然而，近期的遗传学研究揭示了癌症驱动基因组织特异性的重要意义。当涉及移植患者时，组织特异性的影响变得更加复杂，因为同一个体内存在两种不同的代谢环境。供体肾组织的致癌潜力在很大程度上尚不明确，但通常认为对肾移植受者构成的风险极小。本综述通过探讨供体和受体微环境如何影响移植受者相关的肾细胞癌风险，对这一观点提出挑战。在此过程中，我们试图阐明终末期肾病相关肾细胞癌与肾移植受者相关肾细胞癌在发病率、发病机制、预后及治疗策略方面的差异。
Renal Cell Carcinoma in End-Stage Kidney Disease and the Role of Transplantation
肿瘤(癌症)患者之家