Department of Dermatology, Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands.
Transpl Int. 2010 Feb;23(2):191-9. doi: 10.1111/j.1432-2277.2009.00975.x. Epub 2009 Sep 29.
Immunosuppressive therapy in renal transplant recipients (RTRs) is associated with an increased risk for the development of (pre)malignancies involving the skin and the female lower genital tract. We assessed whether yearly cervical screening was performed and evaluated the development of skin cancer and gynaecological (pre)malignancies in RTRs. Female RTRs (n = 224), transplanted between 1991 and 1995, were analysed retrospectively. Sociodemographic patient characteristics, frequency and results of cervical smears and prevalence of cutaneous, cervical, vaginal or vulvar (pre)malignancies were investigated and compared with that in the general population. A mean of 0.2 cervical smears per patient per year was found to have been performed in RTRs, which is significantly less than the recommended screening ratio of 1.0 for female RTRs (P < 0.001). The risk for RTRs to develop malignancies of the female lower genital tract was increased: twofold to sixfold for cervical intraepithelial neoplasia, threefold for cervical carcinoma and 50-fold for vulvar carcinoma. Cervical screening is not performed in accordance with the advised yearly intervals, and the risk for RTRs to develop vulvar and cervical (pre)malignancies is increased. More attention should be paid to the vulvar and cervical surveillance of RTRs by both medical specialists and general physicians.
肾移植受者（RTR）的免疫抑制治疗与皮肤和女性下生殖道（前）恶性肿瘤的发生风险增加有关。我们评估了 RTR 是否进行了年度宫颈筛查，并评估了皮肤癌和妇科（前）恶性肿瘤的发展情况。回顾性分析了 1991 年至 1995 年间接受移植的 224 名女性 RTR。调查了社会人口学患者特征、宫颈涂片的频率和结果以及皮肤、宫颈、阴道或外阴（前）恶性肿瘤的发生率，并与普通人群进行了比较。发现 RTR 每年平均每例患者进行 0.2 次宫颈涂片，明显低于女性 RTR 建议的 1.0 筛查比例（P<0.001）。RTR 发生女性下生殖道恶性肿瘤的风险增加：宫颈上皮内瘤变增加 2 倍至 6 倍，宫颈癌增加 3 倍，外阴癌增加 50 倍。宫颈筛查未按建议的每年间隔进行，RTR 发生外阴和宫颈（前）恶性肿瘤的风险增加。医学专家和普通医生都应更加关注 RTR 的外阴和宫颈监测。
