School of Translational Medicine, Manchester Academic Health Sciences Centre, University of Manchester, United Kingdom.
Dermatol Surg. 2011 Sep;37(9):1239-44. doi: 10.1111/j.1524-4725.2011.02060.x. Epub 2011 Jun 2.
Despite numerous case reports, epidemiologic evidence regarding true rate of skin cancer in scars of any etiology is sparse.
Systematic literature review of all published epidemiologic studies on skin cancer in scar tissue from surgery, ulcers, or burns using citation databases and manual review.
There were no epidemiologic data to quantify risk of skin cancer in surgical scars or chronic ulcers. Two eligible cohort studies were identified, from Denmark and Sweden, in which skin cancers in 16, 903 and 37,095 burn patients, respectively, were ascertained through cancer registry follow-up. Each reported standardized incidence ratios (SIRs) for skin cancer types on any site that were uniformly less than unity compared with the general population. Only the Danish cohort assessed skin cancers specifically on past burn injury sites and found a burn-site-specific SIR of 1.2 (95% confidence interval (CI)=0.4-2.7) for squamous cell carcinoma (SCC), 0.7 (95% CI=0.4-1.1) for basal cell carcinoma, and 0.3 (95% CI=0.0-1.2) for melanoma.
Available epidemiologic data suggest that burn patients are not at higher risk of skin cancers in general, although a modest excess of SCC in burn scars cannot be excluded, nor can excess risk with longer follow-up. Risk of skin cancer in scars other than burn scars has not been investigated epidemiologically.
尽管有大量病例报告，但关于任何病因的疤痕中皮肤癌的确切发生率的流行病学证据仍然很少。
使用引文数据库和手动检索，对所有关于手术、溃疡或烧伤疤痕组织中皮肤癌的已发表的流行病学研究进行系统的文献回顾。
没有流行病学数据来量化手术疤痕或慢性溃疡中皮肤癌的风险。确定了两项符合条件的队列研究，分别来自丹麦和瑞典，通过癌症登记处的随访，分别确定了 16903 例和 37095 例烧伤患者的皮肤癌。每个报告的任何部位皮肤癌的标准化发病率比（SIR）均低于普通人群。只有丹麦队列专门评估了过去烧伤损伤部位的皮肤癌，发现鳞状细胞癌（SCC）的烧伤部位特异性 SIR 为 1.2（95%置信区间（CI）=0.4-2.7），基底细胞癌为 0.7（95%CI=0.4-1.1），黑色素瘤为 0.3（95%CI=0.0-1.2）。
现有的流行病学数据表明，烧伤患者的皮肤癌总体风险并不高，尽管不能排除烧伤疤痕中 SCC 的适度增加，也不能排除随访时间更长时的风险增加。尚未对除烧伤疤痕以外的疤痕中的皮肤癌风险进行流行病学研究。
