特集名 | 末期腎不全患者の悪性腫瘍 | |
---|---|---|
題名 | 透析患者の悪性腫瘍:透析患者に多発するのか (2) 九州・沖縄地区 | |
発刊年月 | 2005年 04月 | |
著者 | 海津 嘉蔵 | 社会保険横浜中央病院腎・血液浄化療法科 |
【 要旨 】 | 末期腎不全患者に悪性腫瘍 (MT) が多いといわれているが,未だ結論が得られていない.九州・沖縄地区で,維持透析患者のMTの疫学調査研究を行った結果について述べる. 2002年12月31日現在の時点で前述の地区の371施設 (23,042名) から回答を得た.[1] MT合併患者数は,男性635名,女性329名で,男性に多かった.[2] 単癌917名,2癌60名,3癌3名であった.[3] 消化器系癌は481名 (46.7%),泌尿器系癌257名 (25.0%),乳癌80名 (7.8%),呼吸器系癌59名(5.7%)の順であった.[4] 標準化罹患比 (SIR) を推定すると,男性では,(1) 腎癌,(2)甲状腺癌,(3)多発性骨髄腫,(4) 肝癌,女性では,(1) 腎癌,(2) 多発性骨髄腫,(3) 膀胱癌,(4) 甲状腺癌の順であった.[5] 透析導入後のMT発生頻度は,透析導入後4年以内に51.7%が診断されていた. 今回の疫学調査は,断面調査であり,疫学調査としては不十分であるため,今回の結果は推測の域を越えない.しかし,それでも,透析患者にMTは多いようである. |
Theme | Malignant Tumors in Patients with End-Stage Renal Failures | |
---|---|---|
Title | Increased prevalence of malignancy in uremic patients on chronic dialysis in Kyushu-Okinawa area | |
Author | Kazo Kaizu | Department of Nephrology & Blood Purification, Social Insurance Yokohama Central Hospital |
[ Summary ] | This study was designed to clarify the incidence of malignant tumor in dialysis patients in the Kyushu-Okinawa area. This questionnaire study covered 71.0 % (23,042 patients) of all chronic dialysis patients (32,468 patients as of 31st, Dec, 2002). There were 980 patients with 1,046 MT (single : 917 pts, double : 60 pts, triple : 3 pts). The largest number of patients with MT was in those where it was observed in the digestive organs. 481 patients had MT of the digestive tract, 257 patients had MT of the urinary tract, 80 patients had MT of the breast, followed by 59 in respiratory system. Standardized incidence rates (SIR) adjusted for sex and age, using cancer incidence rates from the cancer registry in Japan was as follows (M / F) : total 3.0 / 3.3, kidney 17.6 / 22.5, thyroid 10.0 / 5.6, multiple myeloma 6.3 / 12.5, bladder 10.0 / 5.6 and liver 5.8 / 4.7, although this is not accurate because of cross-sectional study. 51.7 % of dialysis patients were diagnosed with MT within four years after initiation of dialysis. Conclusion : The risk of MT for dialysis patients may increase compared to population controls. The MTs of the kidney, liver, colon, bladder, thyroid and multiple myeloma showed higher incidence rates in dialysis patients than in control populations. |