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[人体器官移植后非黑色素瘤皮肤癌的临床研究]

[Clinical study of non-melanoma skin cancer following human organ transplantation].

作者信息

Fekecs Tamás, Kádár Zsolt, Battyáni Zita, Kalmár-Nagy Károly, Szakály Péter, Wéber György, Horváth Ors Péter, Ferencz Andrea

机构信息

Pécsi Tudományegyetem, Klinikai Központ Bor-, Nemikórtani és Onkodermatológiai Klinika 7624 Pécs Kodály Zoltán út 20.

出版信息

Magy Seb. 2010 Apr;63(2):84-90. doi: 10.1556/MaSeb.63.2010.2.6.

Abstract

INTRODUCTION

Increasing evidence suggests that non-melanoma skin cancers (NMSC) are the most frequent tumours in transplanted patients. In this study, we present the first Hungarian dermatological screening program to establish the incidence of NMSC after organ transplantations.

PATIENTS AND METHODS

116 adult, "Caucasian" (white skin) transplanted (kidney, simultaneous-pancreas-kidney) patients (70 male and 46 female) of the Surgical Department of Pécs University were enrolled from September 2008. All patients underwent a a full skin examination by a dermatologist for NMSC as well as a standardized questionnaire was filled in to assess risk factors.

RESULTS

Screening resulted in 16 NMSC (13.8%, median age: 49.3 years, male : female = 1 : 1) diagnoses with a median duration from transplantation of 4.1 years. Histology showed 13 basal cell carcinoma (BBC), 3 squamous cell carcinoma (SCC), with a 4 : 1 ratio of BCC : SCC. Incidence of NMSC was significantly higher on patients who were treated with cyclosporine as immunosuppressant, who had more than 2 sunburns prior to transplantation, or had outdoor workplace ( p < 0.05).

CONCLUSIONS

These data confirm the importance of skin cancer surveillance in transplant recipients via a close cooperation between Transplantation and Dermatological Centres. Our results reflect the international data, except for the BCC : SCC ratio. Further studies needed to elucidate this difference.

摘要

引言

越来越多的证据表明,非黑色素瘤皮肤癌(NMSC)是移植患者中最常见的肿瘤。在本研究中,我们介绍了首个匈牙利皮肤病筛查项目,以确定器官移植后NMSC的发病率。

患者与方法

2008年9月起,招募了佩奇大学外科的116名成年“白种人”(白皮肤)移植患者(肾移植、胰肾联合移植)(男性70例,女性46例)。所有患者均由皮肤科医生进行全面的皮肤检查以筛查NMSC,并填写标准化问卷以评估危险因素。

结果

筛查出16例NMSC(13.8%,中位年龄:49.3岁,男性:女性 = 1:1),自移植后的中位时间为4.1年。组织学检查显示13例基底细胞癌(BBC),3例鳞状细胞癌(SCC),BCC:SCC比例为4:1。接受环孢素作为免疫抑制剂治疗、移植前有超过2次晒伤或户外工作场所的患者,其NMSC发病率显著更高(p < 0.05)。

结论

这些数据证实了通过移植中心和皮肤科中心密切合作对移植受者进行皮肤癌监测的重要性。除了BCC:SCC比例外,我们的结果反映了国际数据。需要进一步研究以阐明这种差异。

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