Lindelöf Bernt, Granath Fredrik, Dal Henrik, Brandberg Yvonne, Adami Johanna, Ullén Henrik
Department of Dermatology, Karolinska Hospital, Stockholm, Sweden.
Acta Derm Venereol. 2003;83(3):189-93. doi: 10.1080/00015550310007193.
Organ transplant recipients are frequently affected by skin cancer, which might also be a major cause of long-term mortality. Excessive sun exposure is considered to be a factor in the aetiology, but uncertainty about the importance of this and other proposed risk factors remains. The purpose of this study was to investigate sun behaviour before and/or after the transplantation in kidney transplant recipients with or without cutaneous squamous cell carcinoma. A nested, population-based, case-control study was carried out on 95 kidney transplant recipients who had contracted cutaneous squamous cell carcinoma after the transplantation and on an accurately matched control population of 154 kidney transplanted patients. Information on sun exposure before and after the transplantation, skin type, use of sunbeds, warts, etc., was obtained from a questionnaire which contained 38 detailed questions. The differences between cases and control subjects were not significant for sun exposure before or after the transplantation, sun protective measures, number of sunburns, outdoor occupation, smoking habits or use of sunbeds. Compared to patients with skin type IV, the cutaneous squamous cell carcinoma odds ratio was 3.0 (95% CI = 1.3-7.0) for skin type I + II. Patients with light blond or red hair colour also had a higher odds ratio than those with dark hair, 3.2 (95% CI = 1.2-8.2), and patients with warts after the transplantation had a higher odds ratio than those without, 2.2 (95% CI = 1.2-4.2). In conclusion, poor tanning ability rather than the amount of sun exposure is associated with the development of cutaneous squamous cell carcinoma in kidney transplant recipients and warts appearing after the transplantation indicate increased risk.
器官移植受者经常受到皮肤癌的影响，这也可能是长期死亡率的主要原因。过度日晒被认为是病因中的一个因素，但关于这一因素以及其他提出的风险因素的重要性仍存在不确定性。本研究的目的是调查肾移植受者在移植前后有或无皮肤鳞状细胞癌的日晒行为。对95例移植后患上皮肤鳞状细胞癌的肾移植受者以及154例精确匹配的肾移植患者对照人群进行了一项基于人群的巢式病例对照研究。关于移植前后的日晒情况、皮肤类型、使用日光浴床情况、疣等信息，通过一份包含38个详细问题的问卷获得。病例组和对照组在移植前后的日晒情况、防晒措施、晒伤次数、户外工作、吸烟习惯或使用日光浴床方面没有显著差异。与IV型皮肤的患者相比，I + II型皮肤的患者发生皮肤鳞状细胞癌的比值比为3.0（95%置信区间 = 1.3 - 7.0）。浅金色或红色头发的患者的比值比也高于深色头发的患者，为3.2（95%置信区间 = 1.2 - 8.2），移植后有疣的患者的比值比高于无疣患者，为2.2（95%置信区间 = 1.2 - 4.2）。总之，肾移植受者中皮肤鳞状细胞癌的发生与晒黑能力差而非日晒量有关，移植后出现的疣表明风险增加。
