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[丹麦器官移植受者的皮肤癌筛查]

[Screening for skin cancer in organ transplant recipients in Denmark].

作者信息

Horn Janne, Lock-Andersen Jørgen, Rasmussen Knud, Jemec Gregor B E

机构信息

Medicinsk Afdeling og Dermatologisk Funktion, Roskilde Amts Sygehus Roskilde, Plastikkirurgisk Afdeling.

出版信息

Ugeskr Laeger. 2005 Jun 20;167(25-31):2762-5.

Abstract

INTRODUCTION

Non-melanoma skin cancer (NMSC) is a serious cause of morbidity and mortality in organ transplant recipients. The necessary immunosuppressive therapy is linked to an increased number of biologically more aggressive acting skin tumours. Preventing disease and providing early diagnosis and treatment is thus essential. This is done through repetitive patient education and regular examination of the skin performed by a trained specialist, i.e., a dermatologist. We investigated the routine level of monitoring for NMSC in organ transplant recipients in Denmark.

MATERIALS AND METHODS

A questionnaire survey was conducted on how hospital departments educate patients in NMSC prevention, the frequency of full-body skin examination and where patients are treated when a tumour is found. The questionnaire was sent to 28 medical departments in Denmark that follow up organ transplant recipients. Twenty-five departments returned the questionnaire.

RESULTS

A full-body skin examination was routinely done in six (24%) of the departments. Fifteen (60%) of the departments informed patients about the risk factors for developing skin cancer, but only five (20%) provided written information.

DISCUSSION

There appears to be considerable scope for improvement in the follow-up of organ transplant recipients. Providing thorough and repeated information to organ transplant patients, in addition to early diagnosis and treatment carried out by trained specialists according to standard guidelines, can minimize the morbidity and mortality caused by non-melanoma skin cancer in these patients. We suggest that written guidelines be provided in order to improve these patients" treatment and prognosis. A corresponding survey done in the United Kingdom produced almost the same conclusions.

摘要

引言

非黑色素瘤皮肤癌(NMSC)是器官移植受者发病和死亡的一个重要原因。必要的免疫抑制治疗与生物学行为更具侵袭性的皮肤肿瘤数量增加有关。因此,预防疾病并提供早期诊断和治疗至关重要。这通过对患者进行反复教育以及由训练有素的专科医生(即皮肤科医生)定期检查皮肤来实现。我们调查了丹麦器官移植受者中NMSC的常规监测水平。

材料与方法

就医院科室如何对患者进行NMSC预防教育、全身皮肤检查的频率以及发现肿瘤时患者的治疗地点进行了问卷调查。问卷被发送给丹麦28个对器官移植受者进行随访的医学科室。25个科室返回了问卷。

结果

六个(24%)科室常规进行全身皮肤检查。15个(60%)科室告知患者患皮肤癌的风险因素,但只有五个(20%)提供了书面信息。

讨论

器官移植受者的随访工作似乎有很大的改进空间。除了由训练有素的专科医生按照标准指南进行早期诊断和治疗外,向器官移植患者提供全面且反复的信息可以将这些患者因非黑色素瘤皮肤癌导致的发病率和死亡率降至最低。我们建议提供书面指南以改善这些患者的治疗和预后。在英国进行的一项类似调查得出了几乎相同的结论。

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