Division of Gastroenterology, Tufts Medical Center, 800 Washington Street, Boston, MA, USA.
Dig Dis Sci. 2010 Nov;55(11):3218-23. doi: 10.1007/s10620-010-1145-1. Epub 2010 Feb 18.
Most patients with autoimmune hepatitis (AIH) require long-term immunosuppressive therapy (IS). While it is well established that solid organ transplant recipients have a high risk of developing non-melanoma skin cancer (NMSC) as a result of immunosuppression, little is known about the risk of NMSC associated with IS in patients with AIH.
The aim of this study is to determine the incidence and risk factors for NMSC in patients on IS for AIH.
We reviewed the medical records of all patients with AIH seen at a tertiary care medical center between 1998 and 2008. We compared the incidence of NMSC to an age- and sex-matched control population and analyzed risk factors for NMSC.
A total of forty-five patients with AIH were identified. Twenty NMSC lesions were found in eight patients. Compared to the age and sex-matched general population, the risk of SCC and BCC were increased as quantified by elevated standardized incidence ratios (28.5 and 5.0, respectively). Patients who developed NMSC were on average 24 years older (78.4 vs. 54.2 years old, p < 0.0001) and had AIH diagnosed at a more advanced age (66.0 vs. 45.4 years old, p = 0.0003).
The risk of NMSC is significantly increased in patients with AIH on immunosuppression. Independent risk factors include current age and age at diagnosis of AIH.
大多数自身免疫性肝炎（AIH）患者需要长期免疫抑制治疗（IS）。虽然已经证实，实体器官移植受者由于免疫抑制而患非黑色素瘤皮肤癌（NMSC）的风险很高，但对于 AIH 患者接受 IS 治疗与 NMSC 相关的风险知之甚少。
本研究旨在确定接受 IS 治疗的 AIH 患者发生 NMSC 的发生率和危险因素。
我们回顾了 1998 年至 2008 年间在一家三级医疗中心就诊的所有 AIH 患者的病历。我们将 NMSC 的发生率与年龄和性别匹配的对照组进行了比较，并分析了 NMSC 的危险因素。
共确定了 45 例 AIH 患者。8 例患者发现了 20 个 NMSC 病变。与年龄和性别匹配的一般人群相比，SCC 和 BCC 的风险通过升高的标准化发病比来量化（分别为 28.5 和 5.0）。发生 NMSC 的患者平均年龄大 24 岁（78.4 岁比 54.2 岁，p<0.0001），AIH 诊断年龄更大（66.0 岁比 45.4 岁，p=0.0003）。
接受免疫抑制治疗的 AIH 患者发生 NMSC 的风险显著增加。独立的危险因素包括当前年龄和 AIH 诊断年龄。
