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[器官移植患者的皮肤癌。流行病学与管理]

[Skin cancer in organ transplant patients. Epidemiology and management].

作者信息

Leiter U, Garbe C

机构信息

Zentrum für Dermato-Onkologie, Universitäts-Hautklinik, Eberhard-Karls-Universität Tübingen, Liebermeisterstr. 25, 72076, Tübingen.

出版信息

Hautarzt. 2010 Mar;61(3):207-13. doi: 10.1007/s00105-009-1862-6.

Abstract

Transplant recipients are at significantly increased risk of cancer development as a long term complication. Skin cancer is the most common cancer, representing 40-50% of post transplant malignancies. In the first 10 years post transplantation, some 15%-40% of patients develop skin cancer, primarily squamous cell carcinoma and basal cell carcinoma, but also melanoma, Merkel cell carcinoma and virally-induced Kaposi sarcoma. The management of skin cancer includes secondary prophylaxis and address attention to areas of widespread actinic damage, usually with topical agents. In high risk skin cancer or metastatic disease a substantial reduction in immunosuppression to switching to mTOR inhibitors appears to substantially improve the prognosis. The management of the individual tumor types is discussed; in general it follows the current guidelines.

摘要

作为一种长期并发症,移植受者患癌症的风险显著增加。皮肤癌是最常见的癌症,占移植后恶性肿瘤的40%-50%。在移植后的前10年,约15%-40%的患者会患上皮肤癌,主要是鳞状细胞癌和基底细胞癌,也有黑色素瘤、默克尔细胞癌和病毒诱导的卡波西肉瘤。皮肤癌的治疗包括二级预防,并关注广泛存在光化性损伤的部位,通常使用局部用药。对于高危皮肤癌或转移性疾病,大幅降低免疫抑制或改用mTOR抑制剂似乎可显著改善预后。文中讨论了各类肿瘤的治疗方法;总体上遵循现行指南。

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