Dinh Quan Q, Chong Alvin H
Department of Medicine (Dermatology), St Vincent's Hospital Melbourne, Fitzroy, Victoria, Australia.
Australas J Dermatol. 2007 Nov;48(4):199-207. doi: 10.1111/j.1440-0960.2007.00387.x.
Population registry data and published studies have demonstrated that melanomas in the transplant population occur 1.6-2.5 times more commonly compared with the general population. Studies examining possible risk factors have suggested that in this patient population, there is an increased number of melanocytic naevi. Whether this phenomenon is aetiologically related to subsequent melanoma development is currently unclear. Only one study examined the prognosis of melanomas in this population. The Israel Penn International Transplant Tumor Registry has collated patient data voluntarily submitted by transplant physicians throughout the USA since 1968. Analysis of melanomas in this study found that approximately half were Breslow thickness >1.51 mm. Overall, there was a high rate of nodal and distant metastases, with poorer 1-, 3- and 5-year survival rates compared with the general population. There is a paucity of good-quality evidence regarding melanoma in organ transplant recipients. Further research involving international collaborative trials, particularly on risk factors and the prognosis of melanomas in this population, could present a more substantial evidence base from which treatment guidelines based on data could be developed.
人口登记数据和已发表的研究表明，移植人群中的黑色素瘤发病率是普通人群的1.6至2.5倍。对可能的风险因素进行研究的结果显示，在这一患者群体中，黑素细胞痣的数量有所增加。目前尚不清楚这种现象在病因上是否与随后发生的黑色素瘤有关。仅有一项研究探讨了该人群中黑色素瘤的预后情况。自1968年以来，以色列宾夕法尼亚国际移植肿瘤登记处一直在整理美国各地移植医生自愿提交的患者数据。该研究对黑色素瘤的分析发现，约一半患者的 Breslow 厚度>1.51 mm。总体而言，淋巴结转移和远处转移的发生率较高，与普通人群相比，1年、3年和5年生存率更低。关于器官移植受者黑色素瘤的高质量证据很少。开展更多涉及国际合作试验的研究，尤其是关于该人群黑色素瘤的风险因素和预后的研究，可能会提供更丰富的证据基础，从而据此制定基于数据的治疗指南。
