| 特集名 | 腎不全における悪性腫瘍 | |
|---|---|---|
| 題名 | おもな癌腫の透析患者における治療成績 (4) 肺癌 | |
| 発刊年月 | 2001年 06月 | |
| 著者 | 大平 整爾 | 日鋼記念病院外科・腎センター |
| 著者 | 辻 寧重 | 日鋼記念病院外科・腎センター |
| 著者 | 阿部 憲司 | 岩見沢市立総合病院外科・透析センター |
| 【 要旨 】 | 種々の癌腫が慢性透析患者には好発することが，統計上示されている．肺癌に関しては，831,804の透析症例を分析したMaisonneuveらによればその好発は明らかではない．一方，本邦の報告を概観すると，肺癌は一般人口に比較して高頻度に発生するものと推測される．文献上に表れた32例を解析したところ，担癌状態での透析導入が約30％にみられるのに対して，透析開始5年後の発生が約45％に認められた．この32例に対しては摘出術，抗癌剤投与，放射線照射などの治療が行われているが，癌死の明確な12例のうち8例(66.7％)が2年未満に死亡しており，予後はきわめて不良であった． 慢性透析患者の胸部X線写真の読影は溢水，石灰沈着，炎症などが高頻度に随伴するために容易ではなく，したがって確定診断までに時間を要する傾向が大である．非侵襲性のCT,MRI,PETによる診断が欠かせないものと考えられた． 今後，多数例を集積し，詳細に分析することが望まれる． |
|
| Theme | Malignancy in Chronic Renal Failure | |
|---|---|---|
| Title | Lung cancer in chronic dialysis patients | |
| Author | Seiji Ohira | Department of Surgery and Kidney Center, Nikko Memorial Hospital |
| Author | Yasushige Tsuji | Department of Surgery and Kidney Center, Nikko Memorial Hospital |
| Author | Kenji Abe | Department of Surgery and Dialysis Center, Iwamizawa Municipal General Hospital |
| [ Summary ] | It has been statistically shown that various cancers are more predominant in chronic dialysis patients than in the general population. As for lung cancer, the report of Maison neuve et al showed no definite increased incidence in this specific group of patients. On the otherhand, Japanese reports revealed that lung cancers were found more frequently in chronic dialysis patients. 32 cases which appeared in Japanese literature were analyzed and the following tentative results were obtained: (1) About 30% of the cases were introduced into dialysis therapy accompanied by lung cancer and the persentage 5 years after initiating dialysis was found to be around 45%. (2) Surgical resection, anti-cancer agents and radiation therapy were carried out on these 32 cases and about 67% of the deaths occurred within 2 years. As chest X-Ps of chronic dialysis patients were frequently accompanied by congestion, calcification and inflammation, etc., readings are difficult. Time is therefore apt to be wasted until a final diagnosis is established. Non-invasive diagnostic means such as CT, MRI and PET should be mandatory in order to obtain an early, definite diagnosis. The accumulation and precise analysis of applicable cases is an important subject for future consideration. | |