中文摘要：

目的研究肝移植术后新发消化系统恶性肿瘤患者的临床特点及预后情况。方法收集和整理2004年1月至2015年12月在浙江大学医学院附属第一医院行肝移植术并接受完整随访的1517例中10例新发消化系统恶性肿瘤患者的临床资料，分析和总结患者的免疫抑制方案、新发肿瘤类型、诊治经过及预后情况。结果肝移植术后新发消化系统恶性肿瘤的发生率为0．7％（10／1517），其中胃癌3例，结肠癌3例，肝癌2例，胰腺癌2例。10例患者均接受相应治疗，同时减少免疫抑制剂用量。肝移植手术至新发肿瘤确诊的中位时间为40．5个月（23～156个月）；新发肿瘤确诊后随访中位时间10．5个月（3～61个月），随访期间有6例死亡，均死于肿瘤进展。结论肝移植术后新发消化系统恶性肿瘤患者预后差，早期诊断和治疗是改善预后的重要途径，因此肝移植术后需进行严密随访，尤其是对于存在高危因素的患者；免疫抑制剂的调整可能是预防及改善预后的有效措施。

英文摘要：

Objective To investigate the clinical features and prognosis of patients with de novo digestive system malignancy after liver transplantation. Methods The clinical data of 10 patients with de novo digestive system malignancy out of 1 517 patients undergoing liver transplantation from January 2004 to December 2015 in the First Affiliated Hospital of Zhejiang University were collected. Immunosuppressive agents, type of de novo malignancy, process of treatment and prognosis were analyzed retrospectively. Results The incidence of de novo digestive system malignancy after liver transplantation was 0. 7% （10/1 517）, including 3 cases of gastric cancer, 3 cases of colon cancer, 2 cases of liver cancer, 2 cases of pancreatic cancer. All of the 10 patients received the corresponding treatment, and the dosage of immunosuppressive agents was reduced at the same time. The median time from liver transplantation to the diagnosis of de novo malignancy was 40. 5 months （23 to 156 months）. The median follow-up time was 10. 5 months （3 to 61 months） after they had been diagnosed as malignancies, and 6 patients died of tumor progression. Conclusions The prognosis of patients with de novo digestive system malignancy after liver transplantation is poor, and early diagnosis and treatment is an important way to improve prognosis. Liver transplant recipients need to be closely followed up, especially in patients with high risk factors of digestive system malignancy. The modification of immunosuppressive drugs may be an effective way to prevent and improve prognosis.