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坦桑尼亚西北部一家大学教学医院白化病患者的皮肤癌:64例回顾性研究

Skin cancers among Albinos at a University teaching hospital in Northwestern Tanzania: a retrospective review of 64 cases.

作者信息

Mabula Joseph B, Chalya Phillipo L, Mchembe Mabula D, Jaka Hyasinta, Giiti Geofrey, Rambau Peter, Masalu Nestory, Kamugisha Erasmus, Robert Ssentongo, Gilyoma Japhet M

机构信息

Department of Surgery, Catholic University of Health and Allied Sciences-Bugando, Mwanza, Tanzania.

出版信息

BMC Dermatol. 2012 Jun 8;12:5. doi: 10.1186/1471-5945-12-5.

Abstract

BACKGROUND

Skin cancers are a major risk associated with albinism and are thought to be a major cause of death in African albinos. The challenges associated with the care of these patients are numerous and need to be addressed. The aim of this study was to outline the pattern and treatment outcome of skin cancers among albinos treated at our centre and to highlight challenges associated with the care of these patients and proffer solutions for improved outcome.

METHODS

This was a retrospective study of all albinos with a histopathological diagnosis of skin cancer seen at Bugando Medical Centre from March 2001 to February 2010. Data collected were analyzed using descriptive statistics.

RESULTS

A total of 64 patients were studied. The male to female ratio was 1.5:1. The median age of patients was 30 years. The median duration of illness at presentation was 24 months. The commonest reason for late presentation was financial problem. Head and the neck was the most frequent site afflicted in 46(71.8%) patients. Squamous cell carcinoma was the most common histopathological type in 75% of cases. Surgical operation was the commonest modality of treatment in 60 (93.8%) patients. Radiotherapy was given in 24(37.5%) patients. Twenty-seven (42.2%) of the patients did not complete their treatment due to lack of funds. Local recurrence following surgical treatment was recorded in 6 (30.0%) patients. Only thirty-seven (61.7%) patients were available for follow-up at 6-12 months and the remaining patients were lost to follow-up.

CONCLUSIONS

Skin cancers are the most common cancers among albinos in our environment. Albinism and exposure to ultraviolet light appears to be the most important risk factor in the development of these cancers. Late presentation and failure to complete treatment due to financial difficulties and lack of radiotherapy services at our centre are major challenges in the care of these patients. Early institution of preventive measures, early presentation and treatment, and follow-up should be encouraged in this population for better outcome.

摘要

背景

皮肤癌是白化病相关的主要风险,被认为是非洲白化病患者的主要死因。护理这些患者面临诸多挑战,需要加以应对。本研究的目的是概述在我们中心接受治疗的白化病患者皮肤癌的发病模式和治疗结果,突出护理这些患者所面临的挑战,并提出改善治疗结果的解决方案。

方法

这是一项对2001年3月至2010年2月在布甘多医疗中心经组织病理学诊断为皮肤癌的所有白化病患者的回顾性研究。收集的数据采用描述性统计进行分析。

结果

共研究了64例患者。男女比例为1.5:1。患者的中位年龄为30岁。就诊时疾病的中位持续时间为24个月。就诊延迟的最常见原因是经济问题。头颈部是最常受累的部位,有46例(71.8%)患者。鳞状细胞癌是75%病例中最常见的组织病理学类型。手术是60例(93.8%)患者最常见的治疗方式。24例(37.5%)患者接受了放疗。27例(42.2%)患者因资金不足未完成治疗。手术治疗后有6例(30.0%)患者出现局部复发。只有37例(61.7%)患者在6至12个月时可进行随访,其余患者失访。

结论

在我们所处环境中,皮肤癌是白化病患者中最常见的癌症。白化病和紫外线暴露似乎是这些癌症发生的最重要危险因素。就诊延迟以及由于经济困难和我们中心缺乏放疗服务而未能完成治疗是护理这些患者的主要挑战。对于这一人群,应鼓励早期采取预防措施、早期就诊和治疗以及随访,以获得更好的治疗结果。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2ad7/3483204/99aa2fc926f4/1471-5945-12-5-1.jpg

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