駭人：癌癥細(xì)胞竟隨器官移植傳播
An extraordinary and terrifying medical case revealed in the July issue of the American Journal of Transplantation proves that organ transplants can pass not only certain infectious diseases to recipients, but in rare cases, also cancer.
《美國移植雜志》七月刊披露的一個(gè)離奇駭人的病例證實(shí)，器官移植不但會(huì)把某些傳染性疾病傳給器官接受者，在極少數(shù)情況下還會(huì)把癌癥傳給接受者。
Patients known to have malignant tumors are often not able to donate their organs, but that was not the case of a 53-year-old woman who died of a stroke in 2007. She had no known conditions that could prevent doctors from transplanting her organs, and repeated tests revealed no sign of cancer. The woman’s kidneys, lungs, liver and heart were transplanted into donor recipients, but instead of saving their lives, they infected four of the five recipients with cancer, while the fifth died of unrelated causes shortly after the transplant.
已知患有惡性腫瘤的病人通常不能捐獻(xiàn)自己的器官，但2007年死于中風(fēng)的一名53歲女性并不屬于這種情況。她沒有任何已知的病癥阻止醫(yī)生移植她的器官，而反復(fù)的檢查也沒有顯示出癌癥的跡象。這名女性的腎、肺、肝及心臟被移植給了幾個(gè)器官接受者，結(jié)果非但沒有救這些人的命，反而讓五個(gè)接受者中的四人都染上了癌癥，而第五個(gè)人在接受器官移植后不久就因其他原因去世。
The four organ recipients had recovered well after the transplants, but 16 months later, the woman who had received the donor’s lung fell ill and was subsequently diagnosed with cancer in the lymph nodes in her chest. Unfortunately, we live in an age when someone is diagnosed with cancer every couple of minutes, but what made this case remarkable was that tests showed the cancerous cells were actually breast cancer cells. Further DNA analysis revealed that they had come from the organ donor.
四個(gè)器官接受者在接受移植后一開始都恢復(fù)得不錯(cuò)，但16個(gè)月之后，接受肺移植的女性就病倒了，隨后被診斷出胸部的淋巴結(jié)有癌細(xì)胞。不幸的是，我們生活在一個(gè)每幾分鐘就有人被診斷出癌癥的年代，但這個(gè)病例的離奇之處在于，測試結(jié)果顯示，這些癌細(xì)胞實(shí)際上是乳腺癌細(xì)胞。進(jìn)一步的DNA分析揭示，乳腺癌細(xì)胞來自器官捐贈(zèng)者。
The lung recipient’s cancer spread and she died about a year after her disease was discovered. At the time, the remaining three organ recipients were notified that the deceased had become infected with cancer from the organ she had received, and advised to get themselves tested regularly just to make sure the same thing doesn’t happen to them. Unfortunately, that wasn’t enough…
接受肺移植女性的癌細(xì)胞擴(kuò)散，并在發(fā)現(xiàn)癌癥一年后去世。此時(shí)醫(yī)院告知其余三位器官接受者，逝者的癌癥來自她被移植的器官，并建議他們定期做檢查，確保他們不會(huì)同樣染上癌癥。不幸的是，這樣的防范還不夠……
In 2011, four years after the transplant, the liver recipient was diagnosed with breast cancer cells in her liver. She was given the option of undergoing another transplant, but she refused for fear of potential complications. She opted for radiation treatment, which proved successful at first, but the cancer returned, and she died in 2014.
2011年，在接受器官移植四年后，接受肝移植的人被診斷出肝臟中有乳腺癌細(xì)胞。醫(yī)生給她的選擇是再一次接受肝移植，但她因擔(dān)心出現(xiàn)潛在并發(fā)癥拒絕了。她選擇接受放射療法，一開始還比較成功，但后來癌癥復(fù)發(fā)，她于2014年去世。
The person who had received the left kidney in 2007, was diagnosed with cancer in 2013, six years after the transplant. The disease had already spread to several organs when it was discovered, and the patient passed away two months later.
2007年接受左腎移植的人于2013年，也就是移植6年后，被診斷出癌癥。發(fā)現(xiàn)癌癥時(shí)癌細(xì)胞已經(jīng)擴(kuò)散到幾個(gè)器官，病人于兩個(gè)月后離世。
The right kidney was transplanted into a 32-year-old man. In 2011, tests revealed breast cancer cells in his transplanted organ, but he underwent another surgery to have the kidney removed, underwent chemotherapy and stopped taking medicine that suppressed his immune system. He has been cancer free for 10 years.
右腎被移植到一個(gè)32歲的男子身上。2011年，檢查結(jié)果顯示，在他被移植的器官內(nèi)發(fā)現(xiàn)了乳腺癌細(xì)胞，但他做了一個(gè)摘除腎臟的手術(shù)，接受了化療，并停服抑制免疫系統(tǒng)的藥物。如今距離他癌癥痊愈已有十年。
"Many reports have shown that cancer transmission can occur in solid organ transplantation,” the authors of the recently published case note wrote. “However, this is the first report describing breast cancer transmission after a multi-organ procedure from one donor to four recipients.”
最近這篇病例解析報(bào)告的作者寫道：“許多報(bào)告顯示，癌癥傳播可能在實(shí)體器官移植中發(fā)生。不過，這是首份描述一對四多器官移植中乳腺癌傳播的病例報(bào)告。”
It’s worth pointing out that while terrifying, this case is incredibly rare. Dr. Lewis Teperman, director of organ transplantation at Northwell Health in New Hyde Park, New York, writes that passing cancer through organ donation is “very uncommon”, with chances varying between 0.01 and 0.05 percent.
值得指出的是，盡管很駭人，這種情況還是十分罕見的。位于紐約新海德公園的諾斯維爾保健集團(tuán)器官移植中心主任路易斯·塔伯曼醫(yī)生寫道，通過器官移植傳播癌癥“很不尋常”，幾率只有0.01%到0.05%之間。
It’s not clear exactly how the breast cancer remained undetected during the screening performed before the transplants, or how it was able to grow in each of the four patients. Researchers believe that the donor may have had “micro metastases”, groups of cells too small to be detected by imaging tests, and that immunosuppressant drugs played a part in helping the cancer spread. Such drugs are taken by organ recipients so that their bodies don’t reject the new organs, but that means that the cancer cells aren’t rejected either.
目前還不清楚為什么器官移植前的篩查沒有檢測出乳腺癌細(xì)胞，以及癌細(xì)胞為什么會(huì)在四個(gè)接受者體內(nèi)生長。研究人員認(rèn)為，捐贈(zèng)者身上的癌細(xì)胞也許有過“微轉(zhuǎn)移”，只是細(xì)胞群太小，影像學(xué)檢查檢測不到。此外，器官接受者服用的免疫抑制劑也有助于癌細(xì)胞擴(kuò)散。接受者服用這種藥物是為了讓身體不排斥新器官，不過這意味著癌細(xì)胞也不受排斥。
"This extraordinary case points out the often fatal consequences of donor-derived breast cancer,” researchers concluded, “and suggests that removal of the donor organ and restoration of immunity can induce complete remission.”
研究人員得出結(jié)論說：“這個(gè)離奇病例說明，源于捐贈(zèng)者的乳腺癌通常是致命的，并指出，摘除捐贈(zèng)移植的器官、恢復(fù)免疫系統(tǒng)的正常運(yùn)轉(zhuǎn)可以免受其害。”
