鳞状细胞癌与疣状角化性皮肤病变有关，但与器官移植患者的普通疣无关。一项病例对照研究。

Squamous cell carcinomas are associated with verrucokeratotic cutaneous lesions but not with common warts in organ-transplant patients. A case-control study.

机构信息

Department of Dermatology, Rouen University Hospital, University of Rouen, Rouen, France.

出版信息

Transplantation. 2010 May 27;89(10):1224-30. doi: 10.1097/TP.0b013e3181d7598b.

DOI:10.1097/TP.0b013e3181d7598b

PMID:20559031

Abstract

BACKGROUND

Warts are thought to be associated with the development of squamous cell carcinoma (SCC) in organ transplant patients. We investigated the association between the different types of warts and SCC in organ transplant patients.

METHODS

A prospective multicenter case-control study was conducted. Cases were patients with a kidney or heart transplant who were referred for a SCC. Controls were organ transplant patients without SCC, individually matched for age, gender, type of organ transplant (heart or kidney), skin phototype, time from transplantation, and center. Four types of warts: flat warts, verrucae vulgares (including palmo-plantar warts and common warts), verrucous papilloma, and verrucokeratotic lesions were compared between cases and controls using conditional logistic regression.

RESULTS

Ninety-nine cases and 169 controls were included. In multivariate analysis, number of rejections, azathioprine, prednisolone and anti-lymphocyte anti-serum or anti-CD3 monoclonal antibodies use, cumulative sun exposure, actinic keratosis, and verrucokeratic lesions (odds ratio [OR] 16.50; 95% confidence interval [CI] 2.82-96.80) were independently associated with SCC, whereas the association with verrucous papilloma was borderline significant (OR 2.21; 95% CI 0.97-8.15). The association between the presence of at least one of these two types of warts (verruco-keratotic lesions and verrucous papilloma) and the occurrence of SCC was highly significant (OR 18.36; 95% CI 3.03-111) when these warts were located in the same area than SCC, whereas no significant association was evidenced when these warts were located in another area (OR 1.02; 95% CI 0.13-5.79).

CONCLUSION

Verrucous papilloma and mainly verrucokeratotic lesions are strongly associated with the risk of SCC in organ transplant patients, whereas the most typical types of warts: verrucae vulgares and flat warts, are not.

摘要

背景

人们认为疣与器官移植患者的鳞状细胞癌（SCC）的发展有关。我们调查了不同类型的疣与器官移植患者 SCC 之间的关联。

方法

进行了一项前瞻性多中心病例对照研究。病例为因 SCC 就诊的肾或心脏移植患者。对照为无 SCC 的器官移植患者，按年龄、性别、器官移植类型（心脏或肾脏）、皮肤光型、移植后时间和中心进行个体匹配。使用条件逻辑回归比较病例和对照之间的四种类型的疣：扁平疣、寻常疣（包括掌跖疣和普通疣）、疣状乳头瘤和疣状角化病。

结果

纳入 99 例病例和 169 例对照。多变量分析显示，排斥反应次数、硫唑嘌呤、泼尼松龙和抗淋巴细胞抗血清或抗 CD3 单克隆抗体的使用、累积日照、光化性角化病和疣状角化病（比值比 [OR] 16.50；95%置信区间 [CI] 2.82-96.80）与 SCC 独立相关，而疣状乳头瘤的相关性具有边界显著性（OR 2.21；95% CI 0.97-8.15）。当这些疣位于与 SCC 相同的区域时，存在至少一种这两种类型的疣（疣状角化病和疣状乳头瘤）与 SCC 的发生之间存在高度显著相关性（OR 18.36；95% CI 3.03-111），而当这些疣位于另一个区域时，没有显著相关性（OR 1.02；95% CI 0.13-5.79）。